Clinical analysis of gastric cancer complicating brain metastases in 18 cases
10.3969/j.issn.1671-8348.2016.20.015
- VernacularTitle:胃癌脑转移18例临床分析
- Publication Type:Journal Article
- Keywords:
stomach neoplasms;
neoplasm metastasis;
brain;
radiotherapy
- From:
Chongqing Medicine
2016;45(20):2782-2785,2788
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical characteristics and prognostic factors in the patients with gastric cancer (GC) complicating brain metastasis(BM) .Methods The clinical data in 18 cases of MC complicating BM in the Jiangxi Provincial Tumor Hospital from January 2004 to December 2013 were retrospectively analyzed and the survival analysis was performed .Results Male was in 13 cases and female was in 5 cases ,the median age was 56 years old(16-83 years old) .All cases had neurological symptoms before diagnosing BM ,and the common symptoms were headache (38 .9% ) ,weakness (33 .3% ) and nausea/vomiting (22 .2% ) . The median time from diagnosing GC to discovering BM was 10 .4 months .The simultaneous BM was in 5 cases and anisotropic BM was in 13 cases .Single BM accounted for 44% and multiple BM accounted for 56% .Thirteen cases (72 .2% ) of BM were compli‐cated by extracranial metastases ,the usual sites were distant lymph nodes ,liver and bone ,which accounting for 92 .3% ,46 .2% and 30 .8% respectively .The cases were divided into 3 groups according to BM tumor treatment mode .The group A(7 cases) was given the dexamethasone symptomatic treatment ;the group B(7 cases) was treated by dexamethasone combined with whole brain radio‐therapy(WBRT );the group C(4 cases) received WBRT plus three dimensional conformal radiatiotherapy on the basis of hormone . The median survival time in all cases was 2 .5 months (95% CI 1 .25-3 .75 months) and 1‐year survival rate was 16 .7% .The me‐dian total survival time in the group A ,B and C was 1 .9 ,2 .5 ,30 .7 months respectively ;compared with the group A ,the total sur‐vival in the group B had no statistical difference(P=0 .46) ,while the group C had obvious survival benefit(P=0 .012) .The univari‐ate analysis found that the patients with the ECOG score (P=0 .012) ,histological classification G1-G2(P=0 .05) ,anisotropic BM (P=0 .039) ,number of other metastasis lesions 0-1(P=0 .005) and receiving radiotherapy had better prognosis ;the multivariate analysis found that the ECOG score(P=0 .012) and complicating other site metastasis (P=0 .009) were the independent prognostic factors in the patients with GC complicating BM .Conclusion GC complicating BM has worse prognosis .The multidisciplinary diag‐nosis and treatment is expected to extend the survival in partial patients .The ECOG score and extracranial metastasis may be the factors for predicting the curative effect of GC patients .
