Incidence and treatment of brain metastasis in patients with esophageal carcinoma

Table 1 Comparison of the clinical characteristics of brain metastasis from esophageal carcinoma patients in different countries n (%)

Clinical characteristic	Japan[19]	United States[20]	China[18]
	n = 36	n = 27	n = 31
	2003-2010	1993-2001	2000-2012
Pathology
Squamous cell carcinoma	23 (64)	2 (7)	26 (83.8)
Adenocarcinoma	5 (14)	22 (82)	3 (9.7)
Small cell carcinoma	5 (14)	0	2 (6.5)
Other	3 (8)	3 (11)	0
RPA class
I	3 (8)	2 (7)	9 (29)
II	11 (31)	21 (78)	19 (61.3)
III	22 (61)	4 (15)	3 (9.7)
Number of BMEC lesions
Single	19 (53)	13 (48)	18 (58.1)
Multiple	17 (47)	14 (52)	13 (41.9)
Location of BMEC
Cerebral hemisphere	25 (69)	5 (18)	47 (75.8)
Cerebellum	8 (22)		15 (24.2)
Other	3 (8)	22 (82)
Other metastatic sites
Yes	25 (69)	19 (70)	16 (51.6)
No	11 (31)	8 (30)	15 (48.4)
Treatment for BMEC
Chemotherapy alone	3 (8)	0	3 (9.6)
RT alone	9 (25)	15 (56)	9 (29)
Surgery alone	12 (33)	6 (22)
Surgery + RT	5 (14)	6 (22)	2 (6.5)
Surgery + chemotherapy	1 (3)
Chemotherapy + RT	1 (3)		11 (35.5)
Surgery + RT + chemotherapy	0		4 (12.9)
Palliative care	5 (14)		2 (6.5)

BMEC: Brain metastasis from esophageal carcinoma.

Table 2 Outcomes of different treatment methods

Study	Number of patients	Treatment	Median survival (mo)	Factors influencing prognosis
Ogawa et al[19]	12	SR + WBRT	9.6	Treatment plan
	24	WBRT	1.8	KPS score
Total	36 (MOS)		3.9
Weinberg et al[20]	4	SR + WBRT	9.6	Liver metastasis
	6	SR	3.8	RPA class
	15	WBRT	3.9
	2	SRT	2.5
Total	27 (MOS)		3.8
Wadhwa et al[23]	20 (MOS)		10.5	None
Kanemoto et al[27]	6	WBRT	1.6	None
	2	SR + WBRT	4.1
	2	SRT	4.0
	1	SRS	18.2
	1	None	0.4
Total	12 (MOS)		2.1
Yoshida[36]	3	SR + WBRT	65.5	None
	7	SR	17.7
	4	SRT	9.5
	3	WBRT	27.1
	(No MOS)

MOS: Overall median survival; KPS: Karnofsky performance status; SR: Surgical resection; SRS: Stereotactic radiosurgery; SRT: Stereotactic radiotherapy; RPA: Recursive partitioning analysis; WBRT: Whole-brain radiation therapy.