Stereotactic radiosurgery for central neurocytomas: an international multicenter retrospective cohort study

doi:10.3171/2020.1.JNS191515

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Title:	Stereotactic radiosurgery for central neurocytomas: an international multicenter retrospective cohort study
Authors:	Hung, Yi-Chieh Lee, Cheng-Chia Yang, Huai-che Mohammed, Nasser Kearns, Kathryn N. Sun, Shi-Bin Mathieu, David Touchette, Charles J. Atik, Ahmet F. Grills, Inga S. Squires, Bryan Ding, Dale Williams, Brian J. Yusuf, Mehran B. Woo, Shiao Y. Liscak, Roman Hanuska, Jaromir Shiao, Jay C. Kondziolka, Douglas Lunsford, L. Dade Xu, Zhiyuan Sheehan, Jason P.
Contributors:	Univ Virginia Hlth Syst, Dept Neurol Surg, Charlottesville Chi Mei Med Ctr, Dept Neurosurg, Dept Surg Chia Nan Univ Pharm & Sci, Dept Recreat & Healthcare Management Taipei Vet Gen Hosp, Neurol Inst, Dept Neurosurg Natl Yang Ming Univ, Sch Med Capital Univ Med Sci, Beijing Neurosurg Inst, Beijing Tiantan Hosp, Gamma Knife Ctr Univ Sherbrooke, Ctr Rech, Ctr Hosp Univ Sherbrooke, Quebec City Cleveland Clin Fdn, Dept Neurosurg, Cleveland William Beaumont Hosp, Dept Radiat Oncol, Royal Oak Univ Louisville, Dept Neurosurg, Louisville Univ Louisville, Dept Radiat Oncol, Louisville Homolce Hosp, Dept Stereotact & Radiat Neurosurg, Prague Homolce Hosp, Dept Neurosurg, Prague Univ Colorado, Ctr Canc, Dept Radiat Oncol, Aurora, CO USA;[Kondziolka, Douglas NYU Langone Hlth Syst, Dept Neurosurg Univ Pittsburgh, Dept Neurosurg, Pittsburgh
Keywords:	central neurocytoma Gamma Knife radiosurgery stereotactic radiosurgery intracranial neoplasms
Date:	2021
Issue Date:	2023-11-11 11:53:14 (UTC+8)
Publisher:	AMER ASSOC NEUROLOGICAL SURGEONS
Abstract:	OBJECTIVE Central neurocytomas (CNs) are uncommon intraventricular tumors, and their rarity renders the risk-to-benefit profile of stereotactic radiosurgery (SRS) unknown. The aim of this multicenter, retrospective cohort study was to evaluate the outcomes of SRS for CNs and identify predictive factors. METHODS The authors retrospectively analyzed a cohort of patients with CNs treated with SRS at 10 centers between 1994 and 2018. Tumor recurrences were classified as local or distant. Adverse radiation effects (AREs) and the need for a CSF shunt were also evaluated. RESULTS The study cohort comprised 60 patients (median age 30 years), 92% of whom had undergone prior resection or biopsy and 8% received their diagnosis based on imaging alone. The median tumor volume and margin dose were 5.9 cm(3) and 13 Gy, respectively. After a median clinical follow-up of 61 months, post-SRS tumor recurrence occurred in 8 patients (13%). The 5- and 10-year local tumor control rates were 93% and 87%, respectively. The 5- and 10-year progression-free survival rates were 89% and 80%, respectively. AREs were observed in 4 patients (7%), but only 1 was symptomatic (2%). Two patients underwent post-SRS tumor resection (3%). Prior radiotherapy was a predictor of distant tumor recurrence (p = 0.044). Larger tumor volume was associated with pre-SRS shunt surgery (p = 0.022). CONCLUSIONS Treatment of appropriately selected CNs with SRS achieves good tumor control rates with a reasonable complication profile. Distant tumor recurrence and dissemination were observed in a small proportion of patients, which underscores the importance of close post-SRS surveillance of CN patients. Patients with larger CNs are more likely to require shunt surgery before SRS.
Relation:	J NEUROSURG, v.134, n.4, pp.1122-1131
Appears in Collections:	[Dept. of Recreation and Health-Care Management] Periodical Articles

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