Cerebral metastases in patients with ovarian cancer treated with chemotherapy

Cerebral metastases are considered an uncommon complication of ovarian carcinoma. In a series of 52 patients treated with platinum, Adriamycin, and cyclophosphamide combination chemotherapy, 6 patients developed cerebral metastases, an incidence (11.6%) higher than that reported by others. The median age of the patients with cerebral metastases was similar to that of patients without this complication. Cerebral metastases occurred as site of first relapse in three of six patients. Only one patient had extraperitoneal disease prior to chemotherapy and four of the six patients had attained a complete response following chemotherapy. Cerebral relapse occurred at 0, 21, 27, 30, 34, and 36 months from original diagnosis of ovarian carcinoma and 0, 9, 11, 19, 25 and 29 months following first treatment with combination chemotherapy. The median survival was 33 months from diagnosis and 28.5 months from first treatment with chemotherapy. This compares with a median survival from diagnosis for the entire series of 30 months (28 months from first treatment). The result of treatment of established metastases was poor. Survival from diagnosis of cerebral metastases was 2, 2, 3, 6, 10, and 41 + months. If other series confirm these findings consideration may need to be given to prophylactic central nervous system radiotherapy for patients achieving complete remission after systemic chemotherapy.