Stereotactic radiosurgery for the treatment of esophageal carcinoma brain metastases.

Abstract

Purpose: The authors evaluated the results of stereotactic radiosurgery (SRS) for the treatment of metastatic brain tumors from esophageal carcinoma.

Methods: We retrospectively analyzed the clinical characteristics and treatment outcomes in 21 patients with metastatic brain tumors from esophageal carcinoma who underwent SRS between July 2011 and February 2019.

Results: 21 patients (25 SRS procedures) of a total of 88 tumors underwent Gamma knife SRS. Tumor histology was adenocarcinoma in 6 patients (28.6%) and squamous cell carcinoma in 15 patients (71.4%). The median age was 66 years (range 58-73). Eleven patients (52.4%) presented with multiple metastases (range 2-11), and 10 . (47.6%) with a single metastasis. The median tumor volume was 0.55 cm3 (range 0.004-44.64 cm3). No complications related to radiosurgical treatment were identified. The local tumor control rate in this group was 94.2 %. The median survival time from the diagnosis of esophageal cancer was 22 months and the median survival from SRS was 16 months. Higher Karnofsky Performance Scale (KPS) at the time of procedure was associated with increased survival (p=0.003). After SRS, 4 patients had subsequent SRS (1 for boost therapy, 3 for new metastatic deposits), 1 patient underwent craniotomy due to tumor progression. Of the 19 patients who have died, 17 (89.5%) succumbed to systemic disease progression and 2 (10.5%) had neurologic deaths.

Conclusion: SRS is an effective and minimally invasive treatment that can prolong survival. Accordingly, SRS could be used as the initial treatment modality, if possible, even in patients with multiple metastases.