Beyin Metastazlı Jinekolojik Kökenli Malignitelerde Prognostik Faktörlerin Analizi

Yıl 2023, Cilt: 23 Sayı: 2, 1 - 8, 06.11.2023

Tahir Eryılmaz Hüseyin Akıllı Ali Ayhan Ahmet Muhteşem Ağıldere

Öz

Amaç: Jinekolojik kökenli beyin metastazı tanısı alan hastaların demografik ve klinik özelliklerini değerlendirmeyi ve beyin metastazi tanısından sonra prognozu etkileyen faktörleri incelemeyi amaçladık.
Materyal ve Metod: Başkent Üniversitesi Jinekolojik Onkoloji Anabilim Dalı'nda 2008-2021 yılları arasında jinekolojik kanser nedeniyle takip edilen ve beyin metastazı tanısı alan 48 hasta retrospektif olarak değerlendirildi. Hastaların demografik, klinik ve patolojik özellikleri ile ilk tanı anından itibaren uygulanan tedavilerin jinekolojik kanserlere göre dağılımı tespit edildi. Beyin metastazı teşhisi konulduktan sonra medyan sağkalım süreleri istatistiksel olarak değerlendirildi. Tanı sonrası beyin metastazi sonrası sağkalımı etkileyen prognostik faktörler istatistiksel olarak analiz edildi.
Bulgular: Beyin metastazi teşhisi konulduktan sonra medyan sağkalım süresi 8 aydı. Over kanserinde 12 ay, endometrial kanserde 4 ay, rahim ağzı kanserinde 8 ay, vulva kanserinde 3 ay, rahim sarkomlarında 4 aydı. Univaryant analizde lezyon sayısı, lokalizasyonu, ekstrakraniyal metastaz durumu ve tedavi yöntemi beyin metastazi sonrası sağkalım ile ilişkili bulunurken, multivaryant analizde lezyon lokalizasyonu ve tedavi yöntemi prognozu etkileyen bağımsız değişkenler olarak bulundu.
Sonuç: Beyin metastazından sonra prognozun en iyi kombine tedavi sonrasında elde edildiği görüldü. Bununla birlikte, tek başına stereotaktik beyin radyoterapisi, tek başına tüm beyin radyoterapisi alan hastalara kıyasla daha iyi bir prognoza sahipti.

Anahtar Kelimeler

jinekolojik malignite, beyin metastazı, prognostik faktör, radyoterapi

Analysis of Prognostic Factors in Malignancies of Gynecological Origin with Brain Metastases

Öz

Objective: We aimed to evaluate the demographic and clinical characteristics of patients diagnosed with brain metastases of gynecological origin and to analyze the factors affecting prognosis after the diagnosis of brain metastases.
Material and Methods: Forty-eight patients with brain metastases who were followed for gynecological cancer in Başkent University's Department of Gynecological Oncology between 2008 and 2021 were evaluated retrospectively. Demographic, clinical, and pathological characteristics of the patients and the distribution of treatments according to gynecological cancers since the time of primary diagnosis were noted. Median survival times after the diagnosis of brain metastasis were evaluated statistically. Prognostic factors affecting the process of brain metastasis and survival after diagnosis were statistically analyzed.
Results: The median survival time after the diagnosis of brain metastasis was 8 months. It was 12 months in cases of ovarian cancer, 4 months for endometrial cancer, 8 months for cervical cancer, 3 months for vulvar cancer, and 4 months for uterine sarcomas. In univariate analysis, lesion number, localization, extracranial metastasis status, and treatment method were found to be associated with survival after brain metastasis, while lesion localization and treatment method were independent variables affecting prognosis in multivariate analysis.
Conclusion: Patients with the best prognosis after brain metastasis were treated with combined therapy. However, stereotactic brain radiotherapy alone had a better prognosis compared to patients who received whole brain radiotherapy alone.

Anahtar Kelimeler

Gynecologic malignancy, Brain metastasis, Prognostic Factor, Radiotherapy

Kaynakça

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