Concomitant radiosurgical and targeted oncological treatment improves the outcome of patients with brain metastases from gastrointestinal cancer

Sep 24, 2026

The study evaluates outcomes for brain metastases from gastrointestinal cancer treated with Gamma Knife Radiosurgery (GKRS) alongside immunotherapy (IT) or targeted therapy (TT). Survival after GKRS is analyzed against general and specific Graded Prognostic Assessment (GPA) and SIR, and factors including age, sex, KPS, extracranial metastases status, number of brain metastases, RPA class, and treatment mode. Multivariate Cox regression shows IT or TT at or after GKRS1 as the only significant predictor of overall survival. Concomitant therapy does not increase adverse radiation effects and local progression remains similar. Results support the safety, efficacy, and survival benefit of concurrent radiosurgical and targeted oncological treatment.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

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Abstract

Introduction

Methods

Study population and data evaluation

Khalaveh etal. Radiation Oncology (2023) 18:197 [https://doi.org/10.1186/s13014-023-02383-5](https://doi.org/10.1186/s13014-023-02383-5) Radiation Oncology RESEARCH Open Access Concomitant radiosurgical and targeted oncological treatment improves the outcome of patients with brain metastases from gastrointestinal cancer Farjad Khalaveh 1, Anna Cho 1, Abdallah Shaltout 1, Helena Untersteiner 1,2, Beate Kranawetter 1, Dorian Hirschmann 1, Philipp Göbl 1, Wolfgang Marik3, Brigitte Gatterbauer 1, Karl Rössler 1, Christian Dorfer 1 and Josa M. Frischer 1* Abstract Background So far, only limited studies exist that evaluate patients with brain metastases (BM) from GI cancer and associated primary cancers who were treated by Gamma Knife Radiosurgery (GKRS) and concomitant immunotherapy (IT) or targeted therapy (TT) . Methods Survival after GKRS was compared to the general and specific Graded Prognostic Assessment (GPA) and Score Index for Radiosurgery (SIR) . Further, the influence of age, sex, Karnofsky Performance Status Scale (KPS), extracranial metastases (ECM) status at BM diagnosis, number of BM, the Recursive Partitioning Analysis (RPA) classes, GKRS1 treatment mode and concomitant treatment with IT orTT on the survival after GKRS was analyzed. Moreover, complication rates after concomitant GKRS and mainly TT treatment are reported. Results Multivariate Cox regression analysis revealed IT or TT at or after the first Gamma Knife Radiosurgery (GKRS1) treatment as the only significant predictor for overall survival after GKRS1, even after adjusting for sex, KPS group, age group, number of BM at GKRS1, RPA class, ECM status at BM diagnosis and GKRS treatment mode. Concomitant treatment with IT or TT did not increase the rate of adverse radiation effects. There was no significant difference in local BM progression after GKRS between patients who received IT or TT and patients without IT or TT. Conclusion Good local tumor control rates and low rates of side effects demonstrate the safety and efficacy of GKRSin patients with BM from GI cancers. The concomitant radiosurgical and targeted oncological treatment significantly improves the survival after GKRS without increasing the rate of adverse radiation effects. To provide local tumor control, radiosurgery remains of utmost importance in modern GI BM management. Keywords Gamma Knife Radiosurgery, Brain metastases, Gastrointestinal cancer, Immunotherapy, Targeted therapy *Correspondence: Josa M. Frischer [josa.frischer@meduniwien.ac.at](josa.frischer@meduniwien.ac.at) 1Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria 2Department of Neurology, Medical University of Vienna, Vienna, Austria 3Department of Radiology, Division of Neuro-and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/l](http://creativecommons.org/l)icenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ([http://creativecommons.org/publicdomain/zero/1.0/](http://creativecommons.org/publicdomain/zero/1.0/)) applies to the data made available in this articl

FAQs

What treatments were compared in this study for brain metastases from gastrointestinal cancer?

Patients received Gamma Knife Radiosurgery (GKRS), and survival outcomes were assessed with the presence of concomitant immunotherapy (IT) or targeted therapy (TT). The study compares survival after GKRS with and without these concomitant treatments.

Which factor significantly predicted overall survival after the first GKRS treatment?

In multivariate Cox regression analysis, IT or TT at or after the first GKRS1 treatment was the only significant predictor for overall survival after GKRS1.

Does concomitant IT or TT increase adverse radiation effects or local progression?

Concomitant treatment with IT or TT did not increase the rate of adverse radiation effects. There was also no significant difference in local brain metastasis progression between patients receiving IT/TT and those without IT/TT.

Sep 24, 2026

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