Kraszkiewicz Malgorzata, Wydmanski Jerzy
Radiotherapy Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, ul. Wybrzeże AK 15, 44-101 Gliwice, Poland.
Rep Pract Oncol Radiother. 2014 Aug 28;20(1):32-7. doi: 10.1016/j.rpor.2014.08.003. eCollection 2015 Jan.
To evaluate different treatment modalities, sequences, and prognostic factors in patients with brain metastases from stomach cancer.
Brain metastases from gastric cancer are rare and late manifestation of the disease, occurring in less than 1% of gastric cancer patients. The prognosis is poor and median overall survival is 1.3-2.4 months. The standard treatment scheme has not yet been described. Most studies present small sample sizes. The choice of treatment scheme is individually based on performance status, number, location and size of metastases, the status of primary tumor and the presence of other metastases.
Sixteen patients diagnosed with brain metastases from gastric cancer in Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch. Patients, mostly men (69%) aged 51-75 years, (median 68.5 years). Thirteen (81.25%) had treatment of primary tumor before diagnosis of brain metastases. Primary metastatic gastric cancer was diagnosed in 6 patients (37.5%), in 3 cases (18.75%) brain was the site of those metastases. Treatment schemes were individually based.
We identified prognostic factors influencing OS: performance status, number of brain metastases, type of treatment. Median OS was 2.8 months. Median time to brain metastases was 12.3 months and it was shorter in patients with pretreatment metastases to other organs. Patients treated with combined treatment had median survival of 12.3 months.
Aggressive treatment schemes are needed to improve the outcome. Prognostic factors such as performance status, number of metastases, dissemination to other organs are helpful in considering the best treatment options.
评估胃癌脑转移患者的不同治疗方式、顺序及预后因素。
胃癌脑转移是该疾病罕见的晚期表现，发生率低于1%的胃癌患者。预后较差，中位总生存期为1.3 - 2.4个月。尚未描述标准治疗方案。大多数研究样本量较小。治疗方案的选择基于个体的体能状态、转移灶的数量、位置和大小、原发肿瘤状态及其他转移灶的存在情况。
在玛丽亚·斯克沃多夫斯卡 - 居里纪念癌症中心及格利维采肿瘤研究所确诊为胃癌脑转移的16例患者。患者多为男性（69%），年龄51 - 75岁（中位年龄68.5岁）。13例（81.25%）在脑转移诊断前已接受原发肿瘤治疗。6例（37.5%）诊断为原发性转移性胃癌，3例（18.75%）脑为转移部位。治疗方案基于个体情况制定。
我们确定了影响总生存期的预后因素：体能状态、脑转移灶数量、治疗类型。中位总生存期为2.8个月。脑转移的中位时间为12.3个月，在其他器官有预处理转移灶的患者中时间更短。接受联合治疗的患者中位生存期为12.3个月。
需要积极的治疗方案来改善预后。诸如体能状态、转移灶数量、向其他器官扩散等预后因素有助于考虑最佳治疗选择。
