title: Brain metastases from stomach cancer - The role of different treatment modalities and efficacy of palliative radiotherapy.
abstract: OBJECTIVE
  To evaluate different treatment modalities, sequences, and prognostic factors in patients with brain metastases from stomach cancer.
  
  
  BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Radiotherapy Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, ul. Wybrzeże AK 15, 44-101 Gliwice, Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Kraszkiewicz
authors.affiliation: Radiotherapy Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, ul. Wybrzeże AK 15, 44-101 Gliwice, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Wydmanski
keywords: Brain metastases; Palliative radiotherapy; Stomach cancer