title: [Clinical analysis of renal cell carcinoma with brain metastases (report of 10 cases)].
abstract: OBJECTIVE
  To investigate the optimal treatment and prognostic factors of renal cell carcinoma with brain metastases (RCCBM) by the analysis of clinical features.
  
  
  METHODS
  The clinical data of 10 patients with RCCBM in our hospital from Jul. 2003 to Aug. 2011 were analyzed retrospectively. The age range of the patients was 48-80 years, and the mean age was 64 years old. Nine patients were male and one patient was female. Six patients had neurological symptoms. Brain metastasis and kidney cancer were found in the same period in 7 patients. Two patients had brain metastases alone, and 8 patients had metastasis in brain and other parts. There were 4 patients had more than 3 brain metastatic foci. Brain metastatic foci located in: frontal lobe in 6 patients, parietal lobe in 2 patients, occipital lobe in 2 patients, cerebellum in 2 patients, temporal lobe in 1 patient, thalamus and basal ganglia in 1 patient.
  
  
  RESULTS
  The overall survival (OS) of 10 patients with RCCBM was 0.8 to 62.6 months, with an average OS of 12.7 months. Two patients refused therapy and those average OS is only 1.4 months. Three patients were performed stereotactic radiotherapy (SRS). The tumor volume of 1 patient reduced >25% and 2 patients showed no progression in magnetic resonance images at 2-months after SRS. Two patients accepted sorafenib treatment and the average OS was 16.7 months. Patients with 3 or more brain metastases had an average OS of 1.9 months, and the average OS of those with less than 3 brain metastases was 20 months. Patients with synchronous or metachronous brain metastases of renal cell carcinoma had an average OS of 6.8 or 26.5 months, respectively. Patients with or without neurological symptoms had an average OS of 17.9 or 4.9 months, respectively.
  
  
  CONCLUSIONS
  For RCCBM patients, SRS could effectively control the local brain metastases while sorafenib could extend the overall survival. With 3 or more metastases, synchronous brain metastases and no neurological symptoms were the adverse prognostic factors of RCCBM.
authors.affiliation: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.affiliation: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Kewen
authors.initials: K
authors.lastname: Zheng
authors.affiliation: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Zhongming
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; Email: lihanzhong@medmail.com.cn.
authors.forename: Hanzhong
authors.initials: H
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms; D002292:Carcinoma, Renal Cell; D018450:Disease Progression; D004847:Epithelial Cells; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery; D012189:Retrospective Studies