Stereotactic radiosurgery for patients with brain metastases from gastroesophageal cancers

• Published in: Journal of neuro-oncology 2023-08, Vol.164 (1), p.147-155
• Main Authors: Taori, Suchet, Wei, Zhishuo, Deng, Hansen, Hadjipanayis, Constantinos G., Lunsford, L. Dade, Niranjan, Ajay
• Format: Article
• Language: English
• Subjects: Brain cancer; Medical prognosis; Medicine; Medicine & Public Health; Metastases; Metastasis; Neurology; Oncology; Prognosis; Radiation; Radiation therapy; Radiosurgery; Survival; Tumors
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1007/s11060-023-04392-6

Background The prognosis of patients with brain metastases from gastroesophageal (GE) cancers remains unclear despite recent advances in systemic therapies. The authors present a large single-institution experience in the use of stereotactic radiosurgery (SRS). Methods A retrospective review of 71 GE cancer patients (64 male, 90.14%) who underwent Gamma Knife SRS was conducted. Overall, 243 brain metastases were treated and the median number of metastases per patient was 2 (range:1–21). The median age at SRS was 66 years (range: 26–85) and the median treatment day KPS was 80 (range: 50–100). The median cumulative tumor volume was 6.7 cc (range: 0.27-104.76) and the median single-session margin dose was 18 Gy (range: 12–20). Results The median overall survival after SRS was 7 months (range: 1–64). At last follow up, 54 (76.06%) patients were deceased, 8 of whom (14.81%) expired secondary to their intracranial metastases. Four patients (5.63%) experienced local tumor progression at a median time of 8 months (range: 2–13) after SRS. Ten patients (14%) experienced new remote tumor development at a median time of 4 months (range: 0–14) after SRS. Whole-brain radiation therapy (2 patients, 20%) and repeat SRS (8 patients, 80%) were used for newly developed tumors. The incidence of transient adverse radiation effects was 8.45%. Conclusions In this study, the 12-month local tumor control rate was 90%. Incidences of adverse radiation effect rates were rare. The median overall survival of 7 months indicates the poor prognosis of patients with brain spread of their GE cancer.