Pleomorphic Xanthoastrocytoma: Multi-Institutional Evaluation of Stereotactic Radiosurgery

Area of Science:

• Neuro-oncology
• Radiation Oncology

Background:

• Pleomorphic xanthoastrocytoma (PXA) is a rare, low-grade glial tumor predominantly affecting young individuals.
• While surgery is the primary treatment, managing residual or recurrent PXA remains challenging.
• Stereotactic radiosurgery (SRS) is explored as a treatment option for these difficult-to-treat cases.

Purpose of the Study:

• To retrospectively evaluate the efficacy and safety of stereotactic radiosurgery (SRS) for pleomorphic xanthoastrocytoma (PXA).
• To assess local control (LC), progression-free survival (PFS), and overall survival (OS) after SRS in PXA patients.
• To identify factors influencing treatment outcomes and analyze adverse radiation effects.

Main Methods:

• Retrospective analysis of 36 patients (53 tumors) with PXA treated with SRS across 11 institutions (1996-2023).
• Data collected included patient demographics, clinical variables, SRS parameters, and treatment outcomes.
• Kaplan-Meier methods estimated LC, PFS, and OS; Cox regression analyzed prognostic factors.

Main Results:

• Local control (LC) was achieved in 77.4% of tumors; 2-year LC was 77.8%.
• Younger age, absence of peritumoral edema, and higher marginal SRS dose correlated with better LC.
• Median overall survival (OS) was 44 months; 5-year OS was 49.3%. Adverse events were minimal.

Conclusions:

• Stereotactic radiosurgery (SRS) demonstrates promising efficacy for managing pleomorphic xanthoastrocytoma (PXA).
• SRS provides effective local control and reasonable survival rates with a favorable safety profile.
• Further research into optimal SRS parameters for PXA is warranted.