[Treatment Outcomes for Six Cases of Gastric Cancer with Brain Metastases]

We examined the treatment outcomes of brain metastases from gastric cancer in our department.

Six cases of brain metastases were reported between June 2013 and August 2023.

At the onset, 5 cases were undergoing chemotherapy for unresectable advanced or recurrent gastric cancer and 1 case was undergoing follow-up observation after gastrectomy. The median time to onset was 11.7 months after the start of chemotherapy and 30.5 months after the end of adjuvant chemotherapy, respectively. The diagnostic trigger was movement disorder in 5 cases, dementia- like symptoms in 1 case, and incidental discovery in 1 case. The tumor diameter and number of brain metastases were 1-3 lesions with <3 cm/17 lesions with <3 cm/2 lesions with ≥3 cm in 3/1/2 cases. Local therapy included stereotactic radiation/whole brain irradiation/operation plus stereotactic radiation, respectively, and systemic chemotherapy was continued in 4 cases. The overall survival was 14.9 months for all patients, 31.5 months for 3 patients, including 2 patients who had a history of nivolumab and 1 patient who was HER2 positive and had only brain and meningeal dissemination as distant metastases, and 3.0 months for the other 3 patients(p=0.025). In addition to local therapy, immune checkpoint inhibitors and molecular targeted drugs may be effective in treating gastric cancer with brain metastasis.