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世界核心医学期刊文摘（妇产科学分册） 2005年第12期1卷 44-45页

作者： Miller D.S. Blessing j.A. schilder j. 张丽娟 Department of Obstetrics and Gynecology University of Texas Southwestern Medical Center at Dallas 5323 Harry Hines Blvd. J7.124 Dallas TX 75390- 9032 United States

Obj.ctives. To estimate the antitumor activity of topotecan in patients with persistent or recurrent carcinosarcoma (malignant mixed mullerian tumors) of the uterus and to determine the nature and degree of toxicity of topotecan in this cohort of patients. Materials and methods. Eligible patients had measurable advanced or recurrent carcinosarcoma of the uterus. Topotecan at a target dose of 1.5 mg/m2 was administered IV daily for 5 days, every 3 weeks, until progression of disease or adverse affects prohibited further therapy. Results. Twenty-seven member institutions entered 51 patients. Of the patients entered, 48 were eligible. Patient characteristics included a median age of 65, with 33% having prior radiation and 92% having prior chemotherapy. Twenty-six patients (54% ) had a performance status (PS) of 0, 18 (38% ) had a PS of 1, and four (8% ) had a PS of 2. Patients received from 1 to 21 (with a median of 2) courses of treatment. The most frequently observed grade 4 toxicities were neutropenia seen in 35 (73% ) patients, leukopenia in 14 (29% ), and thrombocytopenia in 10 (21% ). Three (6% )- patients developed neutropenic sepsis and died shortly after their first treatment cycle. There were five (10% ) complete responses; 13 (27% ) patients maintained stable disease, 26 (54% ) experienced increasing disease, and reassessment did not occur in four (8% ). Conclusion. Topotecan at this dose and schedule does not appear to have maj.r activity in patients with advanced or recurrent uterine carcinosarcoma previously treated with chemotherapy.

关键词：妇科肿瘤癌肉瘤拓扑替康靶剂量治疗周期毒性反应队列研究脓毒症白细胞减少抗肿瘤活性

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Brain Metastases in Patients with Gynecologic Cancers: A Single Institution Experience and Review of the Literature

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Open j.urnal of Obstetrics and Gynecology 2016年第9期6卷 544-552页

作者： Madiha A. Gilani Noelle L. Williams Carolyn Giordano Norman Rosenblum Wenyin Shi Pramila Anne Russell j. schilder Thomas j.fferson University Hospital Philadelphia PA USA Department of Radiation Oncology Sidney Kimmel Cancer Center Thomas Jefferson University Hospital Philadelphia PA USA Office of Institutional Research Thomas Jefferson University Philadelphia PA USA Sidney Kimmel Cancer Center Thomas Jefferson University Hospital Philadelphia PA USA

Obj.ctive: Brain Metastasis (BM) from primary gynecologic cancers is a rare entity. The advances and successes in the treatment of primary gynecologic malignancies, have led to prolonged survival and, a higher incidence of BM. This study aims to report the experience at our institution in managing these patients, and provide possible data points that may be essential to note as prognostic factors, and see if our findings are consistent with the literature in this subj.ct. We also aim to provide a brief literature review of patients with gynecologic cancers and BM. Methods: This is a small single institution retrospective study of 23 patients with a gynecologic malignancy and BM, identified between the years 2007-2015. Data were collected on variables including patient demographics, disease and treatment. Results: The median overall survival from the primary diagnosis was 28 months. Median time from diagnosis of BM to death was 9 months. Conclusion: The outcomes in our study are similar to what is stated in the current literature with regard to BM from gynecologic malignancies. Our literature search also revealed that the molecular analysis and treatment of the primary tumor remain important to prevent BMs. The tendency of tumors to metastasize varies for one tumor type to another for the same type of tumor. The tendency to develop BM may not only depend on risk factors such as stage, grade, and histology, but also on the genetic profile of the primary tumor. The study suggests that multimodal treatment of BM has better outcomes in managing BM from gynecologic cancers.

关键词： Gynecologic Malignancies Brain Metastasis Prognostic Factors Multimodality Therapy

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