An incidence of cerebral
metastases secondary to
epithelial ovarian cancer as high as 11.6% has been reported in small series and related to the prolonged survival of
ovarian cancer patients treated with
platinum compounds (Hardy, J. R., and Harvey, V. J. Gynecol. Oncol. 33, 296-300, 1989). A review of the histories of 413
ovarian cancer patients, treated from 1981 to 1989 with
platinum-based
combination chemotherapy according to the protocols of the Gruppo Oncologico Nord Ovest (GONO) (North West Oncology Group), showed that only 9 patients (2.2%) developed clinical evidence of cerebral
metastases. Six of 9 patients had FIGO Stage IIIc disease and 1 each with FIGO Stages Ic, IIc, and IV. All these patients had received
cisplatin or
carboplatin-based
combination chemotherapy. Clinical response to initial cytotoxic
therapy was as follows: complete response, 3 patients; partial response, 4 patients; stable disease, 1 patient; progressive disease, 1 patient. Cerebral
metastases occurred at a median of 19 months (range 3-36) from diagnosis and median survival of patients with central nervous system (CNS)
metastasis was 26 months (range 10-81) from diagnosis of primary disease and 8 months (range 1-45) from diagnosis of CNS involvement. The incidence of CNS
metastases in our series is similar to that reported in the past and significantly lower than figures reported by the above mentioned paper. On the basis of our data we do not agree with Hardy and Harvey about the relationship possibly existing between prolonged survival and incidence of CNS
metastases and, particularly, about the need for prophylactic
cranial irradiation.