- 期刊
Brain Metastasis from Colorectal Cancer: A Retrospective Study of 39 Patients
大腸直腸癌發生腦部轉移：有關39位病人之回溯性研究
摘要
目的 大腸直腸癌發生腦部轉移為罕見之合併症，為進一步了解這群病人接受不同治療後之預後因子及結果，我們進行回溯性研究。 方法 從1992年六月到2001年十二月，在林口長庚醫院共收集了39位大腸直腸癌病人發生腦部轉移，並對他們的臨床徵候，存活及預後加以分析報告。 結果 這些病人的年齡從41歲到78歲，其中六位是同時性發生，其他33位是異時性發生。平均診斷時間距離原發腫瘤為664天。大多數(85%)的病人同時有其他位置之轉移。最常見的是肺部(64%)，其次是肝臟(30%)。平均的存活是167天，一年的存活率是14%。在14位接受外科手術切除腫瘤之病人，其中間存活為334天；18位接受放射治療是87天；3位化學治療是62天；其他4位未接受任何治療其中間存活為28天。外科手術切除及單一腦部轉移是兩項有意義的預後因素。 結論 我們因此建議對於這群大腸直腸癌發生腦部轉移病人選擇性予以手術治療。
並列摘要
Purpose. Brain metastases in colorectal cancer is rare. To additionally understand the prognostic factors and outcome after different treatment, a retrospective study was thus conducted. Methods. Between 1992 June and 2001 December, 39 patients who developed brain metastasis from colon cancer in Chang Gung Memorial Hospital-Taipei was recorded. Univariate anaslysis for survival and prognosis determination was performed. Results. Thirty-nine patients were recruited with age ranging from 41 to 78 years old. Six patients had synchronous brain metastasis while 27 patients had metachronous brain metastasis with mean diagnostic interval 664 days. The majority (85%) of patients suffered from concurrent systemic metastases and the most common site is lung (64%) followed with liver (30%). Average survival of all patients was 167 days and one year survival rate was 14%. The median survival was 334 days in 14 surgically totally removed patients, 87 days in 18 radiation therapy treated patients, 62 days in 3 chemotherapy patients, 28 days in 4 patients who did not receive any treatment. Surgical removal tumor and solitary brain metastases were two significant prognostic factors. Conclusion. Brain metastases is rare in colorectal cancer with poor prognosis. Our data suggests that surgery combined with radiation treatment could provide longer survival than that in other treatment.