Abstract:

Aim: Gastrointestinal cancers rarely metastasize to the brain and constitute 4-8% of all brain metastases (BM). Survival is generally poor for BM from gastrointestinal cancers and stereotactic radiosurgery (SRS) is frequently used in its management. Since the data are still insufficient due to their rare presentation, we aim to analyze the clinical results of patients who underwent SRS for BM due to gastrointestinal cancers. Material and Method: We retrospectively reviewed patients with BM from gastrointestinal cancers who received robotic SRS with CyberKnife at our institute from October 2013 to December 2022. Clinical characteristics and treatment outcomes were recorded. Study endpoints were local control rates, distant brain control rates, and overall survival (OS). Results: A total of 61 BM were detected in 42 patients. The median clinical follow-up time was 7 (0.5-36) months. Nine lesions progressed in the irradiated area, 14 new lesions were observed outside the irradiated area. The local control rate was 85.1% and the distant brain control rate was 77%. The median OS was 8 months; 12-month and 24-month OS were 31.6% and 10.5%, respectively. Patients with high performance status had better OS (p=0.016). The prognostic scoring scales RPA and GI-GPA were both associated with OS (p=0.049, p=0.002). Multivariate analysis found a significant association between GI-GPA classes and OS (p=0.011). Conclusion: We obtained comparable results in terms of local control, distant brain control and OS in this challenging patient population. The use of GI-GPA prognostic scoring scales in routine practice will guide the selection of the most appropriate patient for SRS.

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