Tumor distribution and survival in six patients with brain metastases fromcervical carcinoma

Objective. The aim of this study was to investigate the patterns of brain i nvolvement and the outcome of patients with brain metastases from cervical carcinoma. Methods. Between January 1982 and November 1999, 1279 patients with brain m etastases were treated at the Cleveland Clinic. Six of them had brain metas tases from cervical carcinoma. We retrospectively reviewed the patient and tumor characteristics at the time of the primary diagnosis as well as at th e time of the brain metastases diagnosis. Results. Brain metastases from cervical carcinoma were rarely accompanied b y systemic disease, but they were commonly accompanied by uncontrolled loca l-regional disease. The median interval from the appearance of the primary carcinoma to the detection of brain metastases in 5 patients was 12 months. Multiple brain Lesions developed in 4 of 6 patients and consisted of multi ple tumors distributed in the cerebral hemispheres (2 patients) or both the cerebral and the cerebellar hemispheres (2 patients). Only 2 patients had a single lesion confined to a cerebral hemisphere. One patient was treated with stereotactic radiosurgery alone, 3 with surgery followed by whole brai n radiation therapy, 1 with whole brain radiotherapy, and 1 each with whole brain radiotherapy and stereotactic radiosurgery. Patients treated with su rgery had a median survival of 8.25 months, while patients treated with who le brain radiotherapy with or without stereotactic radiosurgery had a media n survival of 3.75 months. The 1 patient treated with stereotactic radiosur gery alone survived for 22.5 months. Conclusion. Although the number of the patients was too small to detect def initive patterns of brain metastases from cervical carcinoma, the results o f our review suggest that, in contrast to previous reports, extended surviv al can occur with more aggressive treatment such as surgery or stereotactic radiosurgery. (C) 2001 Academic Press.