Georgios Mantziaris1, Joshua Diamond1, Stylianos Pikis1, Farid M El Hefnawi2, Ghusn Al Sideiri2, François-Louis Coupé3, David Mathieu3, Cheng-Chia Lee4, Jaromir May5, Roman Liščák5, Selcuk Peker6, Yavuz Samanci6, Ajay Niranjan7, L Dade Lunsford7, Jason P Sheehan1. 1. 1Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia. 2. 2Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio. 3. 3Department of Neurosurgery, Université de Sherbrooke, Centre de recherche du CHUS, Sherbrooke, Quebec, Canada. 4. 4Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. 5. 5Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic. 6. 6Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey; and. 7. 7Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Abstract
OBJECTIVE: The optimal treatment for recurrent and residual gangliogliomas remains unclear. The aim of this study was to evaluate the safety and efficacy of stereotactic radiosurgery (SRS) in the management of patients with recurrent or residual intracranial ganglioglioma. METHODS: This retrospective multicenter study involved patients managed with SRS for ganglioglioma. The study endpoints included local tumor control and tumor- or SRS-related neurological morbidity following treatment. Factors associated with tumor progression and neurological morbidity were also analyzed. RESULTS: The cohort included 20 patients (11 males [55%]) with a median age of 24.5 (IQR 14) years who had been managed with SRS for ganglioglioma. Five-year radiological progression-free survival was 85.6%. After SRS, 2 patients (10%) experienced transient neurological deterioration. At a median clinical follow-up of 88.5 (IQR 112.5) months, 1 patient (5%) experienced seizure worsening and 1 (5%) required further resection of the tumor because of radiological progression. No mortality was noted in this series. CONCLUSIONS: SRS appears to be a safe and effective treatment option for surgically inaccessible, recurrent, and residual gangliogliomas. In this series, the 5-year progression-free survival rate after SRS was 85.6%. Gross-total resection remains the primary treatment of choice for patients with newly diagnosed or recurrent ganglioglioma. SRS may be considered for patients unfit for surgery and those with surgically inaccessible newly diagnosed, residual, and recurrent lesions.
OBJECTIVE: The optimal treatment for recurrent and residual gangliogliomas remains unclear. The aim of this study was to evaluate the safety and efficacy of stereotactic radiosurgery (SRS) in the management of patients with recurrent or residual intracranial ganglioglioma. METHODS: This retrospective multicenter study involved patients managed with SRS for ganglioglioma. The study endpoints included local tumor control and tumor- or SRS-related neurological morbidity following treatment. Factors associated with tumor progression and neurological morbidity were also analyzed. RESULTS: The cohort included 20 patients (11 males [55%]) with a median age of 24.5 (IQR 14) years who had been managed with SRS for ganglioglioma. Five-year radiological progression-free survival was 85.6%. After SRS, 2 patients (10%) experienced transient neurological deterioration. At a median clinical follow-up of 88.5 (IQR 112.5) months, 1 patient (5%) experienced seizure worsening and 1 (5%) required further resection of the tumor because of radiological progression. No mortality was noted in this series. CONCLUSIONS: SRS appears to be a safe and effective treatment option for surgically inaccessible, recurrent, and residual gangliogliomas. In this series, the 5-year progression-free survival rate after SRS was 85.6%. Gross-total resection remains the primary treatment of choice for patients with newly diagnosed or recurrent ganglioglioma. SRS may be considered for patients unfit for surgery and those with surgically inaccessible newly diagnosed, residual, and recurrent lesions.
Authors: Chloe Dumot; Stylianos Pikis; Georgios Mantziaris; Zhiyuan Xu; Rithika Kormath Anand; Ahmed M Nabeel; Darrah Sheehan; Kimball Sheehan; Wael A Reda; Sameh R Tawadros; Khaled Abdel Karim; Amr M N El-Shehaby; Reem M Emad Eldin; Selcuk Peker; Yavuz Samanci; Tehila Kaisman-Elbaz; Herwin Speckter; Wenceslao Hernández; Julio Isidor; Manjul Tripathi; Renu Madan; Brad E Zacharia; Lekhaj C Daggubati; Nuria Martínez Moreno; Roberto Martínez Álvarez; Anne-Marie Langlois; David Mathieu; Christopher P Deibert; Vivek R Sudhakar; Christopher P Cifarelli; Denisse Arteaga Icaza; Daniel T Cifarelli; Zhishuo Wei; Ajay Niranjan; Gene H Barnett; L Dade Lunsford; Greg N Bowden; Jason P Sheehan Journal: J Neurooncol Date: 2022-09-27 Impact factor: 4.506