Department of Neurosurgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea.
Acta Neurochir (Wien). 2010 Apr;152(4):605-10. doi: 10.1007/s00701-009-0554-4. Epub 2009 Nov 12.
We retrospectively evaluated the survival of patients with brain metastases from advanced gastric cancer (AGC) after radiosurgery (RS).
Between 1998 and 2007, a total of 11 patients (median age, 61 years; range, 36-70) were diagnosed with brain metastasis from AGC and treated with RS. Each of five (46%) patients had two brain metastases. The median volume of the 16 lesions was 2.9 cm(3) (range, 0.1-33.8). The median marginal dose prescribed was 20 Gy (range, 10-25) at the 50% isodose line. RS was the primary treatment for brain metastases in six patients.
As of February 28, 2008, eight (73%) patients had died, and three (27%) were living with stable disease. The median survival time was 17.0 +/- 3.9 months (95% CI, 9.4-24.6). The median progression-free survival time was 9.0 +/- 2.5 months (95% CI, 4.2-13.8). Patients who did not undergo WBRT died within 8 months, and the other six patients treated with WBRT at various time intervals from the diagnosis of brain metastases survived, with a median survival time of 19.0 +/- 3.4 months (95% CI, 12.4-25.6).
Radiosurgery seems to be a good alternative to surgical resection for patients with brain metastases from AGC, when performed in conjunction with WBRT.
我们回顾性评估了立体定向放射外科（RS）治疗晚期胃癌（AGC）脑转移患者的生存情况。
1998 年至 2007 年间，共有 11 例（中位年龄 61 岁；范围 36-70 岁）AGC 脑转移患者接受 RS 治疗。5 例（46%）患者各有 2 个脑转移灶。16 个病灶的中位体积为 2.9cm³（范围 0.1-33.8）。中位处方边缘剂量为 20Gy（范围 10-25），在 50%等剂量线。RS 是 6 例患者脑转移的主要治疗方法。
截至 2008 年 2 月 28 日，8 例（73%）患者死亡，3 例（27%）患者疾病稳定。中位生存时间为 17.0±3.9 个月（95%CI，9.4-24.6）。中位无进展生存时间为 9.0±2.5 个月（95%CI，4.2-13.8）。未行 WBRT 的患者在 8 个月内死亡，而其他 6 例在脑转移诊断后不同时间间隔行 WBRT 的患者存活，中位生存时间为 19.0±3.4 个月（95%CI，12.4-25.6）。
当与 WBRT 联合使用时，立体定向放射外科似乎是 AGC 脑转移患者的一种很好的手术切除替代方法。
