Brain Metastases from Epithelial Ovarian Cancer: A Review of the Literature

• Published in: The oncologist (Dayton, Ohio) Ohio), 2006-03, Vol.11 (3), p.252-260
• Main Authors: Pectasides, Dimitrios, Pectasides, Melina, Economopoulos, Theofanis
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - therapeutic use; Brain metastases; Brain Neoplasms - diagnosis; Brain Neoplasms - epidemiology; Brain Neoplasms - secondary; Brain Neoplasms - therapy; Chemotherapy; Chemotherapy, Adjuvant; Female; Humans; Incidence; Neoplasm Staging; Ovarian Neoplasms - epidemiology; Ovarian Neoplasms - pathology; Radiosurgery; Radiotherapy, Adjuvant; Stereotactic radiosurgery; Surgery; Whole‐brain radiotherapy
• ISSN: 1083-7159; 1549-490X
• DOI: 10.1634/theoncologist.11-3-252

Learning Objectives After completing this course, the reader will be able to: Select the appropriate treatment strategies for ovarian cancer patients with solitary brain metastases and extracranial disease. Describe the most important prognostic factors for ovarian cancer patients with brain metastases. List the diagnostic steps needed to establish the diagnosis of brain metastases in ovarian cancer patients. Access and take the CME test online and receive 1 AMA PRA category 1 credit at CME.TheOncologist.com Background. Brain metastases from epithelial ovarian cancer (EOC) are rare. This report is based on a review of the literature. Methods and Results. This review summarizes the incidence, clinical features, pathophysiology, and diagnostic evaluation of EOC. The section on current treatment includes a thorough evaluation of the literature, highlights controversies over treatment options, and provides insight into novel approaches. Current treatment options include surgical resection, whole‐brain radiation therapy (WBRT), stereotactic radiosurgery, and chemotherapy. Corticosteroids and anticonvulsant medications are commonly used for the palliation of mass effects and seizures, respectively. In the reviewed series, a better outcome was seen following surgical resection and WBRT with or without chemotherapy for solitary and resectable brain metastases. Conclusion. The prognosis for patients with brain metastases from EOC is poor. A better outcome might be obtained using multimodality therapy. Because of the small number of patients included in the reported studies, multicenter clinical trials are needed for further investigation in order to critically evaluate the clear benefit of these treatment options in selected patients.