Acta Neurochirurgica

, Volume 152, Issue 4, pp 605–610 | Cite as

Radiosurgery for brain metastasis from advanced gastric cancer

  • Jung Ho Han
  • Dong Gyu KimEmail author
  • Hyun-Tai Chung
  • Chae-Yong Kim
  • Chul-Kee Park
  • Young Seob Chung
  • Sun Ha Paek
  • Moon-Won Yoo
  • Baek-Hui Kim
  • Hee-Won Jung
Clinical Article



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 cm3 (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.


Brain metastasis Advanced gastric carcinoma Gamma Knife radiosurgery Whole-brain radiotherapy 



This study was supported by grant no. 11-2008-027 from the SNUBH Research fund and was partially supported by Nuclear Research & Development Program of the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korean government (MEST) (grant no. M20090078163). The statistical analysis was supported by the Medical Research Collaborating Center, Seoul National University Hospital.


  1. 1.
    Al-Shamy G, Sawaya R (2009) Management of brain metastases: the indispensable role of surgery. J Neurooncol 92:275–282CrossRefPubMedGoogle Scholar
  2. 2.
    Bono P, Bartoloni Saint Omer F (1994) A rare case of bilateral metastasis in the cerebellopontine angle. Pathologica 86:324–328PubMedGoogle Scholar
  3. 3.
    Han JH, Kim DG, Chung HT, Park CK, Paek SH, Kim CY, Jung HW (2008) Gamma knife radiosurgery for skull base meningiomas: long-term radiologic and clinical outcome. Int J Radiat Oncol Biol Phys 72:1324–1332PubMedGoogle Scholar
  4. 4.
    Hasegawa T, Kondziolka D, Flickinger JC, Lunsford LD (2003) Stereotactic radiosurgery for brain metastases from gastrointestinal tract cancer. Surg Neurol 60:506–514 discussion 514–505CrossRefPubMedGoogle Scholar
  5. 5.
    Kakar A, Sethi PK, Agarwal CS, Bhalla S, Mahajan M (1998) Leptomeningeal and brain metastasis in a young patient of signet ring cell carcinoma of stomach. J Assoc Phys India 46:320–321Google Scholar
  6. 6.
    Kasakura Y, Fujii M, Mochizuki F, Suzuki T, Takahashi T (2000) Clinicopathological study of brain metastasis in gastric cancer patients. Surg Today 30:485–490CrossRefPubMedGoogle Scholar
  7. 7.
    Kim M (1999) Intracranial involvement by metastatic advanced gastric carcinoma. J Neurooncol 43:59–62CrossRefPubMedGoogle Scholar
  8. 8.
    Kobayashi M, Araki K, Matsuura K, Kawai S, Moriki T (2002) Early gastric cancer giving rise to bone and brain metastases–a review of the Japanese literature. Hepatogastroenterology 49:1751–1754PubMedGoogle Scholar
  9. 9.
    Lee JL, Kang YK, Kim TW, Chang HM, Lee GW, Ryu MH, Kim E, Oh SJ, Lee JH, Kim SB, Kim SW, Suh C, Lee KH, Lee JS, Kim WK, Kim SH (2004) Leptomeningeal carcinomatosis in gastric cancer. J Neurooncol 66:167–174CrossRefPubMedGoogle Scholar
  10. 10.
    Nomura T, Yoshikawa T, Kato H, Nikkuni K, Sasaki K, Shirai Y, Hatakeyama K (1997) Early gastric cancer manifested as brain metastasis: report of a case. Surg Today 27:334–336CrossRefPubMedGoogle Scholar
  11. 11.
    Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655CrossRefPubMedGoogle Scholar
  12. 12.
    Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, Markesbery WR, Macdonald JS, Young B (1990) A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322:494–500PubMedCrossRefGoogle Scholar
  13. 13.
    Schwesinger G, Pusinelli WD (1974) Acoustic neurinoma with metastases of a carcinoma of the stomach (author's transl). Zentralbl Allg Pathol 118:473–475PubMedGoogle Scholar
  14. 14.
    York JE, Stringer J, Ajani JA, Wildrick DM, Gokaslan ZL (1999) Gastric cancer and metastasis to the brain. Ann Surg Oncol 6:771–776CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Jung Ho Han
    • 4
  • Dong Gyu Kim
    • 1
    Email author
  • Hyun-Tai Chung
    • 1
  • Chae-Yong Kim
    • 1
  • Chul-Kee Park
    • 1
  • Young Seob Chung
    • 1
  • Sun Ha Paek
    • 1
  • Moon-Won Yoo
    • 2
  • Baek-Hui Kim
    • 3
  • Hee-Won Jung
    • 1
  1. 1.Department of NeurosurgerySeoul National University College of MedicineSeoulKorea
  2. 2.Department of SurgeryKonkuk University School of MedicineSeoulKorea
  3. 3.Department of PathologyKorea University College of MedicineSeoulKorea
  4. 4.Department of NeurosurgerySeoul National University Bundang HospitalGyeonggi-doKorea

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