Role of stereotactic radiosurgery in the management of pineal parenchymal tumors.

We evaluated 20 pineal parenchymal tumor patients who underwent radiosurgery at our institution over a 20-year period. Thirteen patients had pineocytoma, 5 patients had pineoblastoma and 2 patients had mixed pineal parenchymal tumors. The median radiosurgery prescription dose to the tumor margin was 15.0 (12-20) Gy. At an average of 54.1 (range, 7.7-149.2) months, 6 patients had died and 14 patients were living. The overall survival after radiosurgery was 95.0, 68.6, and 51.4% at 1, 5 and 10 years, respectively. Patients with pineocytomas had 1-, 3- and 5-year overall survivals of 100, 92.3 and 92.3%, respectively. In 19 patients who were evaluated with imaging, 5 (26%) demonstrated complete regression, 9 (47%) had partial regression, 2 (11%) had stable tumors and 2 (11%) showed local in-field progression. The progression-free survival after stereotactic radiosurgery for all type of pineal parenchymal tumors was 100, 89.2 and 89.2% at 1, 3, 5 years after radiosurgery, respectively. Stereotactic radiosurgery is an effective and safe alternative to the surgical resection of pineocytomas as well as part of multimodal therapy for more aggressive pineal parenchymal tumors. Copyright (c) 2009 S. Karger AG, Basel.