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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2019, Vol. 13 ›› Issue (11) : 828 -831. doi: 10.3877/cma.j.issn.1674-0785.2019.11.006

所属专题： 文献；

临床研究

肾细胞癌根治术后脑转移的治疗：8例报告并文献回顾
鲁润春1, 李良1, 伊志强1, 杨洋2,†()   
  1. 1. 100034　北京大学第一医院神经外科
    2. 100034　北京大学第一医院泌尿外科
  • 收稿日期:2019-05-15 出版日期:2019-06-01
  • 通信作者: 杨洋

Treatment of brain metastasis after radical nephrectomy for renal cell carcinoma: report of eight cases and review of the literature

Runchun Lu1, Liang Li1, Zhiqiang Yi1, Yang Yang2,†()   

  1. 1. Department of Neurosurgery, Peking University First Hospital, Beijing 100034, China
    2. Department of Urology, Peking University First Hospital, Beijing 100034, China
  • Received:2019-05-15 Published:2019-06-01
  • Corresponding author: Yang Yang
  • About author:
    Corresponding author: Yang Yang, Email:
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引用本文：

鲁润春, 李良, 伊志强, 杨洋. 肾细胞癌根治术后脑转移的治疗：8例报告并文献回顾[J]. 中华临床医师杂志(电子版), 2019, 13(11): 828-831.

Runchun Lu, Liang Li, Zhiqiang Yi, Yang Yang. Treatment of brain metastasis after radical nephrectomy for renal cell carcinoma: report of eight cases and review of the literature[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(11): 828-831.

目的

分析肾细胞癌根治性切除术后脑转移的临床特点、治疗方式及预后，探讨局部切除的作用及预后影响因素。

方法

回顾性分析2005年3月至2019年5月北京大学第一医院神经外科收治的肾细胞癌脑转移患者的临床资料。对患者进行随访，并绘制生存曲线。

结果

8例肾细胞癌脑转移患者，男性5例，女性3例，年龄42~70岁，中位年龄63岁。脑转移发生距肾癌根治时间7~103个月，中位时间41个月。8例患者共行9次手术，切除10个颅内转移灶。随访时间为38~204个月，中位随访时间为95个月。8例患者中死亡3例，生存5例。脑转移手术后总生存时间为6~86个月，中位生存时间23个月。

结论

肾癌脑转移患者的预后较差，手术局部切除结合放疗能够达到满意的局部控制，并延长患者生存期。

关键词: 肾细胞癌, 脑转移, 手术治疗, 靶向治疗, 放射治疗
Objective

To investigate the clinical features, treatments, and prognosis of brain metastasis after local resection for renal cell carcinoma.

Methods

Clinical data of patients with brain metastasis after nephrectomy for renal cell carcinoma at Peking University First Hospital between March 2005 and May 2019 were analyzed retrospectively. The patients were followed and survival curves were plotted.

Results

A total of eight patients were included in the study, including 5 males and 3 females aged 42-70 years old, with a median age of 63 years old. Brain metastasis occurred 7-103 months after the treatment of renal carcinoma, and the median time was 41 months. Eight patients received nine operations, and 10 intracranial metastases were resected. The follow-up time was 38-204 months, and the median follow-up time was 95 months. Three of the eight patients died. The total survival time after brain metastasis surgery was 6-86 months, and the median survival time was 23 months.

Conclusion

The prognosis of patients with brain metastases after nephrectomy for renal cell carcinoma is poor, and local resection combined with radiotherapy can achieve satisfactory local control and prolong survival in selected cases.

Key words: Carcinoma, renal cell, Neoplasm metastasis, Surgical treatment, Targeted therapy, Radiation therapy
图1 肾细胞癌脑转移患者手术切除局部转移灶后生存曲线
图2 肾细胞癌脑转移患者局部转移灶切除术后局部（颅内）无进展生存曲线
图3 肾细胞癌根治术后远期合并脑转移患者生存曲线
1
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