Tumor distribution and survival in six patients with brain metastases from cervical carcinoma

The aim of this study was to investigate the patterns of brain involvement and the outcome of patients with brain metastases from cervical carcinoma.

Between January 1982 and November 1999, 1279 patients with brain metastases were treated at the Cleveland Clinic. Six of them had brain metastases from cervical carcinoma. We retrospectively reviewed the patient and tumor characteristics at the time of the primary diagnosis as well as at the time of the brain metastases diagnosis.

Brain metastases from cervical carcinoma were rarely accompanied by systemic disease, but they were commonly accompanied by uncontrolled local-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 multiple 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 brain radiation therapy, 1 with whole brain radiotherapy, and 1 each with whole brain radiotherapy and stereotactic radiosurgery. Patients treated with surgery had a median survival of 8.25 months, while patients treated with whole brain radiotherapy with or without stereotactic radiosurgery had a median survival of 3.75 months. The 1 patient treated with stereotactic radiosurgery alone survived for 22.5 months.

Although the number of the patients was too small to detect definitive patterns of brain metastases from cervical carcinoma, the results of our review suggest that, in contrast to previous reports, extended survival can occur with more aggressive treatment such as surgery or stereotactic radiosurgery.