Gamma-knife radiosurgery in pediatric cerebral and skull base tumors

This retrospective study of 12 children with cerebral or skull base tumors was undertaken to evaluate morbidity and outcome after gamma-knife surgery.

Twelve consecutive children treated with stereotactic radiosurgery in a curative intent were reviewed. There were five girls and seven boys. The mean age at diagnosis was 5.8 years and at radiosurgical treatment 8.4 years. There were four pilocytic astrocytomas, two craniopharyngeomas, two pineoblastomas, two ependymomas, and two other tumors of high malignancy. We used a 201-source Co60 Leksell gamma knife and all children were treated in general anesthesia.

The mean tumor volume was 3.7 cm(3) and the mean tumor margin dose was 13.8 Gy. Seven patients remained stable after gamma-knife treatment with a mean follow- up of 78.6 months. One patient died during follow-up. The remaining four patients had progressive disease, two within and two outside the irradiated field, and have received further treatment. They are still alive with and without disease with a mean follow-up of 96.8 months.

Gamma-knife surgery is an effective treatment in some non-resectable cerebral and skull base pediatric tumors. In most cases, it is used in combination with other therapeutic modalities. It is safe and well tolerated.