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Stereotactic
radiosurgery for brain metastases from gastrointestinal tract cancer
Hasegawa T, Kondziolka D,
Flickinger JC, Lunsford LD
Department
of Neurological Surgery, Pittsburgh, Pennsylvania 15213, USA.
Background.
Outcomes in patients with brain metastases from gastrointestinal tract cancers
are not well defined.
In this study we used precise, single-session, focal tumor irradiation
(radiosurgery) in patients with brain metastases and evaluated the
results.
Methods.
Thirty-nine patients had brain metastases from gastrointestinal tract cancer and
were treated with radiosurgery.
Thirty-two also had whole brain radiotherapy.
Primary lesions included colorectal cancer (n = 25), esophageal cancer (n = 11),
cholangiocarcinoma (n = 1), duodenal cancer (n = 1), and jejunal cancer (n =
1).
Seventy-two tumors were treated.
Results.
The overall median survival was 9 months after diagnosis of metastatic brain
disease and 5 months after radiosurgery.
The 1-year survival rate after radiosurgery was 19%.
The last imaging study of 49 tumors showed complete remission (CR) in 3 tumors
(6.1%), partial remission (PR) in 27 tumors (55.1%), no change (NC) in 11 tumors
(22.4%), and progression in 8 tumors (16.3%).
The local tumor control rate (CR, PR, NC) was 84%.
Two patients (5.1%) had a new or worsening neurologic deficit after
radiosurgery.
Conclusions.
Stereotactic radiosurgery provides reasonable local control of brain metastases
from gastrointestinal tract cancer with few side effects.
However, it should be used judiciously in patients with active extracranial
cancers since the expected survival may be limited.
PMID: 14670663 [PubMed - in process]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14670663&dopt=Abstract |
