Impact of Stereotactic Radiosurgery on GI Cancer Brain Metastases Outcomes

A recent study conducted across two U.S. medical centers has revealed that patients with brain metastases stemming from gastrointestinal (GI) cancers experience significantly worse survival rates following stereotactic radiosurgery compared to those with metastases from non-GI cancers. The findings, published in the journal *Advances in Radiation Oncology* on June 17, 2025, underscore a critical need for enhanced patient care and monitoring in this demographic.

The study, led by Dr. Jamiluddin J. Qazi of Duke University Medical Center, analyzed a cohort of 1,383 patients who underwent stereotactic radiosurgery between January 2015 and December 2020. Among these patients, 102 had brain metastases originating from primary GI cancers, including colorectal, esophageal, and other types. In contrast, 1,281 patients had metastases from non-GI cancers, primarily lung cancer, breast cancer, and genitourinary cancers.

According to the study, the median overall survival for patients with GI cancers was notably shorter, at 5.4 months, compared to 10.6 months for those with non-GI cancers. The 12-month survival rates reflected this disparity, with only 22.6% of GI cancer patients surviving beyond one year, as opposed to 46.2% of patients with other cancer types. The researchers adjusted for various factors, including age, sex, prior therapy, and metastatic burden, yet the findings indicated a significant hazard ratio of 1.92 for worse overall survival among patients with GI cancers.

Additionally, intracranial progression-free survival (PFS) was markedly lower for GI cancer patients, with a median PFS of 6.2 months compared to 12.3 months for non-GI cancers. The 12-month PFS was reported at 18.5% for GI cancers versus 42.0% for non-GI cancers, further highlighting the challenges faced by this patient group. Dr. Qazi and his team noted a trend suggesting that patients with colorectal cancer might experience slightly better outcomes compared to those with esophageal cancer, though the differences were not statistically significant.

The implications of these findings are profound. As Dr. Qazi stated, “Patients with brain metastases from GI cancer are at a higher risk for poor outcomes after stereotactic radiosurgery and may benefit from enhanced surveillance and oncologic care.” The study’s limitations included the fact that most non-GI patients had primary lung cancer, where advancements in targeted therapies may have played a role in improving outcomes. Furthermore, patients with GI cancer tended to present with more advanced disease and had received more systemic therapy, factors that could have influenced their survival rates.

These results prompt a reevaluation of treatment protocols for patients with GI cancer brain metastases. Enhanced monitoring and tailored treatment strategies could potentially improve survival outcomes for this vulnerable population. As the healthcare community continues to seek effective interventions, the findings from this study represent a critical step towards understanding and addressing the unique challenges faced by patients with brain metastases from GI cancers.

In conclusion, the study indicates a pressing need for further research and development of specialized treatment approaches aimed at improving the prognosis for patients with GI cancer brain metastases. By acknowledging the distinct challenges presented by this group, healthcare providers can work towards more effective management and care strategies, ultimately aiming to enhance patient outcomes in this challenging clinical landscape.