Treatment and Prognosis of Brain Metastases From Gynecological Cancers

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  • OGAWA Kazuhiko
    Department of Radiology, University of the Ryukyus School of Medicine
  • YOSHII Yoshihiko
    Department of Neurosurgery, University of the Ryukyus School of Medicine
  • AOKI Yoichi
    Department of Obstetrics and Gynecology, University of the Ryukyus School of Medicine
  • NAGAI Yutaka
    Department of Obstetrics and Gynecology, University of the Ryukyus School of Medicine
  • TSUCHIDA Yukihiro
    Department of Neurosurgery, University of the Ryukyus School of Medicine
  • TOITA Takafumi
    Department of Radiology, University of the Ryukyus School of Medicine
  • KAKINOHANA Yasumasa
    Department of Radiology, University of the Ryukyus School of Medicine
  • TAMAKI Wakana
    Department of Radiology, University of the Ryukyus School of Medicine
  • IRAHA Shiro
    Department of Radiology, University of the Ryukyus School of Medicine
  • ADACHI Genki
    Department of Radiology, University of the Ryukyus School of Medicine
  • HIRAKAWA Makoto
    Department of Obstetrics and Gynecology, University of the Ryukyus School of Medicine
  • KAMIYAMA Kazuya
    Department of Obstetrics and Gynecology, University of the Ryukyus School of Medicine
  • INAMINE Morihiko
    Department of Obstetrics and Gynecology, University of the Ryukyus School of Medicine
  • HYODO Akio
    Department of Neurosurgery, University of the Ryukyus School of Medicine
  • MURAYAMA Sadayuki
    Department of Radiology, University of the Ryukyus School of Medicine

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Abstract

Brain metastases from gynecological cancers were retrospectively investigated in 18 patients who were treated between 1985 and 2006. Six patients received surgical resection followed by radiotherapy, and 12 patients received only radiotherapy. The median survival for all patients was 4.1 months (range 0.7-48.2 months), and the actuarial survival rates were 11% at both 12 months and 24 months. Univariate analysis showed that treatment modality, extracranial disease status, total radiation dose, number of brain metastases, and Karnofsky performance status (KPS) all had statistically significant impacts on survival. Two patients survived for more than 2 years, and both had single brain metastasis, inactive extracranial disease, 90-100% KPS, and were treated with surgical resection followed by radiotherapy. Improvements in neurological symptoms were observed in 10 of the 12 patients treated with palliative radiotherapy, with median duration of 3.1 months (range 1.5-4.5 months). The prognoses for patients with brain metastases from gynecological cancers were generally poor, although selected patients may survive longer with intensive brain tumor treatment. Palliative radiotherapy was effective in improving the quality of the remaining life for patients with unfavorable prognoses.<br>

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