[Clinical outcomes in patients with brain metastasis from gastric cancer]

Brain metastasis from gastric cancer is uncommon and difficult to treat. Patients with brain metastasis had a poor prognosis with simultaneous and multiple metastases to other organs. Four patients with brain metastasis were reported. All patients were male with the median age of 76 years and the diagnosis was stage IA in one, stage IIIA in 2 and stage IV in one. Three patients underwent gastrectmy and one patient in stage IV received chemotherapy as the initial treatment. An interval between the initial treatment and the diagnosis of brain metastasis was 11, 24, 30 and 83 months, respectively. The symptoms of brain metastasis were stagger in two, unconsciousness in one and headache in one. The treatment for brain metastases were a surgical resection for two lesions larger than 3 cm and gamma-knife radiotherapy was performed for the other lesions. The duration of survival from the treatment for brain metastasis was 45, 48, 58 and 94 days, respectively. Multidisciplinary treatment, including a surgical resection and stereotactic radiosurgery such as gamma-knife for brain metastasis is thought to improve the quality of life, but not prolong survival due to metastases to other organs. The development of effective systemic treatment will be necessary in order to prolong survival.