Gamma Knife radiosurgery as a primary treatment for central neurocytoma

Chiman Jeon MD, Kyung Rae Cho MD, Jung Won Choi MD, PhD, Doo-Sik Kong MD, PhD, Ho Jun Seol MD, PhD, Do-Hyun Nam MD, PhD and Jung-Il Lee MD, PhD
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  • Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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OBJECTIVE

This study was performed to evaluate the role of Gamma Knife radiosurgery (GKRS) as a primary treatment for central neurocytomas (CNs).

METHODS

The authors retrospectively assessed the treatment outcomes of patients who had undergone primary treatment with GKRS for CNs in the period between December 2001 and December 2018. The diagnosis of CN was based on findings on neuroimaging studies. The electronic medical records were retrospectively reviewed for additional relevant preoperative data, and clinical follow-up data had been obtained during office evaluations of the treated patients. All radiographic data were reviewed by a dedicated neuroradiologist.

RESULTS

Fourteen patients were treated with GKRS as a primary treatment for CNs in the study period. Seven patients (50.0%) were asymptomatic at initial presentation, and 7 (50.0%) presented with headache. Ten patients (71.4%) were treated with GKRS after the diagnosis of CN based on characteristic MRI findings. Four patients (28.6%) initially underwent either stereotactic or endoscopic biopsy before GKRS. The median tumor volume was 3.9 cm3 (range 0.46–18.1 cm3). The median prescription dose delivered to the tumor margin was 15 Gy (range 5.5–18 Gy). The median maximum dose was 30 Gy (range 11–36 Gy). Two patients were treated with fractionated GKRS, one with a prescription dose of 21 Gy in 3 fractions and another with a dose of 22 Gy in 4 fractions. Control of tumor growth was achieved in all 14 patients. The median volume reduction was 26.4% (range 0%–78.3%). Transient adverse radiation effects were observed in 2 patients but resolved with improvement in symptoms. No recurrences were revealed during the follow-up period, which was a median of 25 months (range 12–89 months).

CONCLUSIONS

Primary GKRS for CNs resulted in excellent tumor control rates without recurrences. These results suggest that GKRS may be a viable treatment option for patients with small- to medium-sized or incidental CNs.

ABBREVIATIONS CN = central neurocytoma; ED = emergency department; GKRS = Gamma Knife radiosurgery; RT = radiation therapy; SRS = stereotactic radiosurgery.

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Contributor Notes

Correspondence Jung-Il Lee: Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. jilee@skku.edu.

INCLUDE WHEN CITING Published online June 19, 2020; DOI: 10.3171/2020.4.JNS20350.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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