肺癌合并眼部转移:单中心回顾性研究并文献综述

背景与目的 眼部转移(ocular metastasis)是肺癌少见转移之一,影响患者生活质量.本研究旨在探讨肺癌合并眼转移患者的临床特征及预后.方法 回顾性分析肺癌合并眼部转移9例患者的临床资料,回顾近10年文献报道共42例患者的临床特点.结果 9例患者的中位年龄为51岁(范围:41岁-61岁),其中7例诊断为非小细胞肺癌(包括腺癌6例);1例为小细胞肺癌;1例病理不详.眼转移部位方面,脉络膜8例,虹膜1例.文献回顾中,小细胞肺癌占21.4%(n=9),腺癌占47.6%(n=20),脉络膜是最常见的眼转移部位(66.7%,n=28).肺癌合并眼转移患者,系统化疗的疾病控制率仅为28%,联合眼部局部治疗可有效控制眼部症状.结论 肺癌合并眼部转移以肺腺癌多见,脉络膜转移是肺癌眼部转移的最常见转移部位.眼部局部治疗可控制局部症状,但系统性化疗疗效差.

Ocular Metastasis in Lung Cancer: a Retrospective Analysis in a Single Chinese Hospital and Literature Review

Background and objective Eye is a rare site of lung cancer metastasis, and ocular metastasis is one of the largest challenges to cancer patients' quality of life (QOL). Here we present our experience on ocular metastasis of lung cancer and review relevant literature in an attempt to investigate the clinical features, treatment, and prognosis of these tumors. Methods The records of 9 patients with ocular metastasis of lung cancer treated at our hospital were analyzed. A literature re-view identified 42 cases reported in the last 10 years and their medical records were retrospectively estimated. Results The me-dian age of our patients was 51 years (range 41-61). Diagnosis of lung cancer included non-small cell lung carcinoma (NSCLC) in 7 patients, in which adenocarcinoma (ADC) were recorded in 6 patients, small cell lung carcinoma (SCLC) in 1 patient, and unknown in 1 patient. The site of ocular metastasis included choroid (n=8) and iris (n=1). In the literature review, SCLC con-stituted 21.4% (n=9) and ADC constituted 47.6% (n=20). Choroid presented to be the most common site for eye metastasis (66.7%, n=28). As for disease control rate, systemic chemotherapy for lung cancer patients with ocular metastasis presented to be only 28%. Meanwhile, combination of systemic treatment with ocular treatment could improve patients' eye symptoms effectively. Conclusion The most common lung cancer that metastasizes to the eye is ADC. The choroid is the most common site for ocular metastasis. Ocular treatment can improve patients' eye symptoms, while the effect of systemic chemotherapy treatment is limited.