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Pineal tumors: analysis of treatment results in 20 patients
Beatriz E Amendola1, Aizik Wolf, Sammie R Coy
1Miami Neuroscience Center, Coral Gables, Florida 33143, USA. bamendola@internationalradonc.com
Object:
The authors evaluate their results when using gamma knife surgery (GKS) in the management of patients with tumors in the pineal region.
Methods:
This is a retrospective clinical evaluation of 20 patients with primary tumors of the pineal region treated with GKS from November 1994 through August 2003. There were 13 germ cell tumors, two pineoblastomas, two low-grade gliomas, one primitive neuroectodermal tumor, one teratoma, and one pineocytoma. There were 10 male and 10 female patients. Their median age was 15.5 years (range 5-71 years). The median margin dose was 11 Gy (range 8-20 Gy). The median target volume was 3.1 cm3 (range 0.1-49.9 cm3). Five patients received sequential systemic chemotherapy and four underwent adjuvant conventional radiation therapy. Seventeen (85%) of 20 patients are alive with a median survival of 30.4 months (range 0-85.7 months). Two patients required retreatment. Three patients died: one of unrelated causes, one who presented with extensive local disease, and the other of meningeal carcinomatosis with local control of the primary tumor. No complications from GKS were noted.
Conclusions:
This initial experience suggests that GKS is a valuable treatment modality for the management of pineal region tumors. This technique offers excellent local tumor control and minimal patient morbidity, allowing for immediate use of systemic chemotherapy and/or conventional radiation if indicated.
Insights
Gamma knife surgery (GKS) effectively manages pineal region tumors, offering excellent local control and minimal side effects. This approach allows for timely adjuvant therapies, improving patient outcomes.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Pediatric Oncology
Background:
- Pineal region tumors are rare and challenging to treat.
- Gamma Knife Surgery (GKS) is an advanced stereotactic radiosurgery technique.
Purpose of the Study:
- To evaluate the efficacy and safety of GKS for pineal region tumors.
- To assess local tumor control and patient survival rates after GKS.
Main Methods:
- Retrospective analysis of 20 patients with primary pineal region tumors treated with GKS.
- Tumor types included germ cell tumors, pineoblastomas, gliomas, and others.
- Median follow-up was 30.4 months, with doses ranging from 8-20 Gy.
Main Results:
- 85% of patients (17/20) survived with a median survival of 30.4 months.
- Excellent local tumor control was achieved with no reported GKS complications.
- Two patients required retreatment; three patients died from various causes.
Conclusions:
- GKS is a valuable and safe treatment option for pineal region tumors.
- The technique provides high rates of local tumor control and low morbidity.
- GKS facilitates concurrent or sequential administration of chemotherapy and conventional radiation therapy.
