Upfront Stereotactic Radiosurgery for Pineal Parenchymal Tumors in Adults.
10.3340/jkns.2015.58.4.334
- Author:
Jong Hoon PARK
1
;
Jeong Hoon KIM
;
Do Hoon KWON
;
Chang Jin KIM
;
Shin Kwang KHANG
;
Young Hyun CHO
Author Information
1. Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. yhyunc@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Pineal parenchymal tumor;
Pineocytoma;
Pineal parenchymal tumors of intermediate differentiation;
Stereotactic radiosurgery
- MeSH:
Adult*;
Biopsy;
Cerebrospinal Fluid;
Diagnosis;
Female;
Follow-Up Studies;
Humans;
Hydrocephalus;
Male;
Memory;
Neoplasm Metastasis;
Pinealoma*;
Radiosurgery*;
Treatment Outcome;
Ventriculostomy
- From:Journal of Korean Neurosurgical Society
2015;58(4):334-340
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Pineal parenchymal tumors (PPTs) in adults are rare, and knowledge regarding their optimal management and treatment outcome is limited. Herein, we present the clinical results of our series of PPTs other than pineoblastomas managed by stereotactic radiosurgery (SRS) at upfront setting. METHODS: Between 1997 and 2014, nine consecutive adult patients with the diagnosis of PPTs, either pineocytoma or pineal parenchymal tumor of intermediate differentiation, were treated with SRS. There were 6 men and 3 women. The median age was 39 years (range, 31-53 years). All of the patients presented with symptoms of hydrocephalus. Endoscopic third ventriculostomy and biopsy was done for initial management. After histologic diagnosis, patients were treated with Gamma Knife with the mean dose of 13.3 Gy (n=3) or fractionated Cyberknife with 32 Gy (n=6). RESULTS: After a mean follow-up of 78.6 months (range, 14-223 months), all patients were alive and all of their tumors were locally controlled except for one instance of cerebrospinal fluid seeding metastasis. On magnetic resonance images, tumor size decreased in all patients, resulting in complete response in 3 patients and partial response in 6. One patient had experienced temporary memory impairment after SRS, which improved spontaneously. CONCLUSION: SRS is effective and safe for PPTs in adults and can be considered as a useful alternative to surgical resection at upfront setting.
