BMET-09. BRAIN METASTASES FROM OVARIAN CARCINOMA: PROGNOSTIC FACTORS AND TREATMENT OUTCOME

Abstract

Between January 1995 and December 2014, 25 patients with ovarian brain metastases were treated at The Sheba Medical Center. The medical records were retrospectively reviewed to collect demographic, clinical and imaging data, treatment modalities and outcome. The mean age of patients at the time of brain metastases diagnosis was 61.2 years. The median interval between the diagnosis of the primary cancer and brain metastases was 39.25 months. Neurological deficit, headache, and seizure were the most common symptoms. The brain was the only site of metastasis in 20% of patients. Active ovarian cancer at the diagnosis of brain metastases was observed in half of the patients with systemic disease. Multiple brain metastases were seen in 25 % of the patients. We treated 12 patients with Surgery + Radiation therapy protocols in various orders: surgery followed by complementary WBRT, surgery followed by SRS, and surgery followed by WBRT and consequently followed by adjuvant SRS. 5 patients underwent surgery alone and 8 patients were treated with radiation alone (WBRT, SRS or both). Univariate analysis for predictors of survival demonstrated that age above 62.7 years old at the time of CNS involvement was a significant risk factor and leptomeningeal disease was found to be a poor prognostic factor in reference to supra-tentorial lesions. However in a multivariate analysis for predictors of survival our results showed that multiple brain lesions (>4) were a poor prognostic factor and a multivariate analysis of time to progression revealed that combined treatments of surgery and radiation resulted in longer median periods of PFS than each modality alone. We conclude that the only significant predictor of survival or PFS in our cohort were the number of brain metastases and the treatment modality accordingly.