title: Treatment and prognosis of brain metastases from gynecological cancers.
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.
authors.affiliation: Department of Radiology, University of the Ryukyus School of Medicine, Okinawa, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yoshii
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Aoki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nagai
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Tsuchida
authors.forename: Takafumi
authors.initials: T
authors.lastname: Toita
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Kakinohana
authors.forename: Wakana
authors.initials: W
authors.lastname: Tamaki
authors.forename: Shiro
authors.initials: S
authors.lastname: Iraha
authors.forename: Genki
authors.initials: G
authors.lastname: Adachi
authors.forename: Makoto
authors.initials: M
authors.lastname: Hirakawa
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kamiyama
authors.forename: Morihiko
authors.initials: M
authors.lastname: Inamine
authors.forename: Akio
authors.initials: A
authors.lastname: Hyodo
authors.forename: Sadayuki
authors.initials: S
authors.lastname: Murayama
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery