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Endoscopic Third Ventriculostomy and Pineal Biopsy from a Single Entry Point
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Stereotactic radiosurgery for pineal tumours.

John Yianni1, Jeremy Rowe, Nader Khandanpour

  • 1Department of Stereotactic Radiosurgery, Royal Hallamshire Hospital, Sheffield, UK.

British Journal of Neurosurgery
|December 16, 2011
PubMed
Summary

Stereotactic radiosurgery (SRS) offers a promising treatment for pineal tumours, achieving high progression-free survival rates. Further research into established therapies alongside SRS may be beneficial.

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Oncology

Background:

  • Pineal tumours present significant clinical challenges.
  • A review of cumulative experience was conducted to inform treatment strategies.

Purpose of the Study:

  • To review the institutional experience with Stereotactic radiosurgery (SRS) for pineal tumours.
  • To formulate a potential treatment strategy based on outcomes.

Main Methods:

  • Retrospective analysis of 44 patients treated with SRS for pineal tumours between 1987 and 2009.
  • Histological data included pineal parenchymal tumours, astrocytomas, ependymomas, papillary epithelial tumours, and germ cell tumours.
  • Patients received prior treatments such as craniotomy, radiotherapy, or chemotherapy, with some referred for primary SRS.

Main Results:

  • Fifty Gamma Knife treatments were administered with a median dose of 18.1 Gy.
  • Mean follow-up was 62.5 months, with overall progression-free survival (PFS) at 93% (1 year), 77% (5 years), and 67% (10-20 years).
  • Higher tumour grade, prior radiotherapy, and necrosis were associated with worse outcomes, impacting 5-year PFS (47.1% vs. 91%). No persistent complications from SRS were noted.

Conclusions:

  • Stereotactic radiosurgery (SRS) plays an increasingly significant role in managing pineal tumours.
  • The findings suggest a re-evaluation of established therapies in conjunction with SRS for this patient group is warranted.