Kazuhiro Yamanaka1, Yoshiyasu Iwai2, Takashi Shuto3, Yoshihisa Kida4, Mitsuya Sato5, Motohiro Hayashi6, Takeshi Kondo7, Hisao Hirai8, Rentaro Hori9, Kenji Kubo10, Hisae Mori11, Osamu Nagano12, Toru Serizawa13. 1. Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan. Electronic address: kyama115@med.osaka-cu.ac.jp. 2. Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan. 3. Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan. 4. Department of Neurosurgery, Komaki City Hospital, Komaki, Aichi, Japan. 5. Department of Neurosurgery, Kitanihon Neurosurgical Hospital, Gosen, Niigata, Japan. 6. Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan. 7. Department of Neurosurgery, Shin-Suma Hospital, Kobe, Hyogo, Japan. 8. Department of Neurosurgery, Koto Memorial Hospital, Higashioumi, Shiga, Japan. 9. Department of Neurosurgery, Shiokawa Hospital, Suzuka, Mie, Japan. 10. Department of Neurosurgery, Koyo Hospital, Wakayama, Japan. 11. Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 12. Department of Neurosurgery, Chiba Cardiovascular Center, Ichihara, Chiba, Japan. 13. Tsukiji Neurological Clinic, Tokyo Gamma Unit Center, Tokyo, Japan.
Abstract
OBJECTIVE: Central neurocytoma (CN) is a rare benign neuronal tumor, and a limited number of reports have described the usefulness of radiosurgery for a relatively large group of patients. We evaluated the effectiveness and outcomes of Gamma Knife radiosurgery (GKS) for CN in a Japanese multi-institutional study. METHODS: We performed retrospective analysis of 36 patients with CN who were treated with GKS in 12 institutes in Japan. All patients underwent surgery before GKS. The median tumor volume at GKS was 4.9 mL (range, 0.07-23.4 mL), and the median radiation dose prescribed to the tumor margin was 15 Gy (range, 10-20 Gy). The median follow-up period was 54.5 months (range, 3-180 months). RESULTS: The local tumor progression-free survival rates at 5 and 10 years were 94% and 86%, respectively. Three patients developed distant dissemination 16-90 months later. Overall progression-free survival was unrelated to the prescribed dose (<15 Gy vs. ≥15 Gy, P = 0.62), tumor size (<6 mL vs. ≥6 mL, P = 0.46), gender (P = 0.36), age (<30 vs. ≥30 years, P = 0.37), target of GKS (residual vs. recurrence, P = 0.90), and type of enhancement (homogeneous vs. inhomogeneous, P = 0.19). Two permanent complications occurred with 1 intratumoral hemorrhage and 1 radiation injury. CONCLUSIONS: GKS is effective for CN because of its high rate of long-term local tumor control. GKS may have a potential role as a primary treatment for asymptomatic, relatively small tumors in the absence of hydrocephalus without surgical resection.
OBJECTIVE:Central neurocytoma (CN) is a rare benign neuronal tumor, and a limited number of reports have described the usefulness of radiosurgery for a relatively large group of patients. We evaluated the effectiveness and outcomes of Gamma Knife radiosurgery (GKS) for CN in a Japanese multi-institutional study. METHODS: We performed retrospective analysis of 36 patients with CN who were treated with GKS in 12 institutes in Japan. All patients underwent surgery before GKS. The median tumor volume at GKS was 4.9 mL (range, 0.07-23.4 mL), and the median radiation dose prescribed to the tumor margin was 15 Gy (range, 10-20 Gy). The median follow-up period was 54.5 months (range, 3-180 months). RESULTS: The local tumor progression-free survival rates at 5 and 10 years were 94% and 86%, respectively. Three patients developed distant dissemination 16-90 months later. Overall progression-free survival was unrelated to the prescribed dose (<15 Gy vs. ≥15 Gy, P = 0.62), tumor size (<6 mL vs. ≥6 mL, P = 0.46), gender (P = 0.36), age (<30 vs. ≥30 years, P = 0.37), target of GKS (residual vs. recurrence, P = 0.90), and type of enhancement (homogeneous vs. inhomogeneous, P = 0.19). Two permanent complications occurred with 1 intratumoral hemorrhage and 1 radiation injury. CONCLUSIONS: GKS is effective for CN because of its high rate of long-term local tumor control. GKS may have a potential role as a primary treatment for asymptomatic, relatively small tumors in the absence of hydrocephalus without surgical resection.
Authors: Austin M Tang; Joshua Bakhsheshian; Michelle Lin; Casey A Jarvis; Edith Yuan; Ian A Buchanan; Li Ding; Ben A Strickland; Eric Chang; Gabriel Zada; William J Mack; Frank J Attenello Journal: J Radiosurg SBRT Date: 2019
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