{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T23:12:00Z","timestamp":1787872320760,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T00:00:00Z","timestamp":1485820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In this study, we assessed clinical outcomes of patients with brain metastases from a gastrointestinal (<jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content>) primary cancer and patterns of failure after stereotactic radiosurgery including failure within the radiosurgical volume, distant failure and leptomeningeal failure (<jats:styled-content style=\"fixed-case\">LMF<\/jats:styled-content>). We also assessed other factors associated with the patients\u2019 neurologic and extraneuraxial disease that may affect clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed our institutional series of 62 consecutive patients with brain metastases treated with stereotactic radiosurgery, which included 17 patients with oesophageal, 44 patients with colorectal and one patient with anal canal primary. The median marginal dose to the radiosurgery volume was 17\u00a0Gy (range 10\u201324\u00a0Gy). Thirteen patients were treated with whole\u2010brain radiotherapy (<jats:styled-content style=\"fixed-case\">WBRT<\/jats:styled-content>) prior to <jats:styled-content style=\"fixed-case\">GKS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median dose delivered to the margin of the tumour was 17\u00a0Gy (range: 10\u201324\u00a0Gy). The median largest tumour diameter was 2.7\u00a0cm (range: 0.60\u20136.1\u00a0cm). The median overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) was 7.1\u00a0months with a median follow\u2010up of 6.1\u00a0months and a range of 0\u201331.7\u00a0months. Freedom from local failure was 86.5% and 62.2% at 6 and 12\u00a0months respectively. Freedom from distant failure was 73.2% and 42.2% at 6 and 12\u00a0months, respectively, and 40% of patients died of neurologic death. <jats:styled-content style=\"fixed-case\">LMF<\/jats:styled-content> occurred in seven patients, all of whom had colorectal primaries. Multivariate analysis revealed that craniotomy for resection of brain metastasis (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u00a0=\u00a02.63, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.02), an absence of extracranial disease (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u00a0=\u00a02.28, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.03), and prolonged time to distant brain failure (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u00a0=\u00a02.85, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01) predicted for improved survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Colorectal cancer metastases tend to have a higher rate of leptomeningeal failure than other types of <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> cancer metastases. Radiosurgical management of brain metastases from <jats:styled-content style=\"fixed-case\">GI<\/jats:styled-content> primary represents an acceptable management option. Neurologic death remains problematic.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.12584","type":"journal-article","created":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T07:23:48Z","timestamp":1485847428000},"page":"522-527","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Gamma Knife radiosurgery for brain metastases from gastrointestinal primary"],"prefix":"10.1111","volume":"61","author":[{"given":"Brandi R","family":"Page","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology and Molecular Sciences Johns Hopkins University Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edina C","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Wake Forest University Baptist Medical Center Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance","family":"White","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Wake Forest University Baptist Medical Center Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emory","family":"McTyre","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Wake Forest University Baptist Medical Center Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Peiffer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Wake Forest University Baptist Medical Center Winston\u2010Salem North Carolina USA"},{"name":"Brain Tumor Center of Excellence Wake Forest University Winston\u2010Salem North Carolina 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