目的 探讨卵巢上皮性癌脑转移的发生率、临床病理特征、治疗方法及预后.方法 回顾性分析中山大学肿瘤防治中心1995年1月至2009年12月收治的13例卵巢上皮性癌脑转移患者的临床资料.结果 13例患者占同期收治的卵巢上皮性癌患者的0.7％ (13/1851),诊断脑转移时中位年龄48岁.从确诊为卵巢上皮性癌至发生脑转移的中位间隔时间为16个月.初诊时76.9％ (10/13)的患者为晚期,病理类型多为浆液性腺癌(10例),病理分级低分化12例、中分化1例.脑转移最常见的首发症状为头痛,颅内病变主要累及双大脑各叶,其次为小脑,累及脑膜者少见.8例患者同时合并颅外脏器转移.发生脑转移后的总体生存时间为0.5 ～172个月,中位生存时间7个月,大部分患者(10/13)在诊断脑转移后1年内死亡.结论 卵巢上皮性癌脑转移发病率低,以低分化浆液性腺癌多见,预后差.个体化综合治疗可改善症状,延长生存期.%Objective To evaluate the incidence, clinicalpathological characteristics, treatment and prognosis of patients with brain metastases from epithelial ovarian carcinoma. Methods The medical records of 13 cases with brain metastases from epithelial ovarian carcinoma treated in Sun Yat-sen University Cancer Center between January 1995 and December 2009 were analyzed retrospectively. Results Thirteen patients accounted for 0.7% of the 1851 women with epithelial ovarian carcinoma in the period. The median age at diagnosis of brain metastases was 48 years. The median interval between primary diagnosis and brain metastases was 16 months (range, 1 ～38 months). 76.9% (10/13) of the cases had advanced stages at primary diagnosis. Serous adenocarcinoma was the prevalent cell type (10/13). Twelve patients had poorly differentiated tumors, and one had moderately differentiated tumor. The most common symptom of brain metastasis was headache. Intracranial metastatic lesions generally involved cerebrum, followed by cerebellum, while leptomen-inges was an uncommon site involved. Eight patients also had extracranial metastases. The median survival from the diagnosis of brain metastases was 7 months ( range, 0. 5 ～ 172 months) . Most patients (10/13) died within one year. Conclusions Brain metastases from epithelial ovarian carcinoma present an uncommon event and suggest a poor prognosis. It usually occurred in poorly differentiated serous adenocarcinoma patients. Individual comprehensive treatments can alleviate the neurologic symptoms and prolong survival time.
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