Gamma Knife Radiosurgery for Metastatic Brain Tumors from Gastric Cancers

Jeong, Seong Kyun; Lee, Sung Ho; Lee, Do Heui; Kwon, Do Hoon

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2014;10(2):86-93.
Published online September 30, 2014.

Gamma Knife Radiosurgery for Metastatic Brain Tumors from Gastric Cancers

Seong Kyun Jeong, Sung Ho Lee, Do Heui Lee, Do Hoon Kwon

Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Objective
Metastatic brain tumors from gastric cancers are rare. Because cerebral metastases are late manifestations of gastric cancers, these tumors are often inoperable. We evaluated the use of gamma knife radiosurgery (GKRS) for metastatic brain tumors from gastric cancer and its impact on tumor control and patient survival.
Methods
We retrospectively analyzed 27 patients with metastatic brain tumors from gastric cancers who were treated with GKRS at Asan Medical Center between 2003 and 2012.
Results
A total of 20 male and seven female patients were treated with GKRS. The mean age was 60.0 years old (range, 31-83 years). An average of 1.7 lesions was treated on initial GKRS, and mean tumor volume was 3,235mm3 . The mean marginal dose of GKRS was 23.1Gy (range, 13.8-28Gy) with an isodose of 50% (range, 33-80%). Mean survival following GKRS was 8 months (range, 1-82 months). Thirteen deaths were of systemic cause and three deaths were due to neurological issues. Thirty-five of 61 GKRS-treated lesions were controlled at follow-up evaluations, and four lesions were found to have progressed. The mean progression-free survival (PFS) was 9.7 months (range, 1-25 months). Ten of 19 initially symptomatic patients experienced improvement of their presenting symptoms. Of the factors we analyzed, only treatment modalities for primary cancer exhibited statistical significance with survival time after GKRS (p＜0.05).
Conclusions
GKRS allowed for good local tumor control and symptom relief. GKRS is a safe alternative treatment for metastatic brain tumors in patients with gastric cancer when surgery is unsuitable.

Key Words: Brain tumor, Gastric cancer, Metastasis, Radiosurgery.