Defining the optimal dose of radiation after incomplete resection of central neurocytomas.
OBJECTIVE
Central neurocytomas are uncommon benign central nervous system tumors. There is uncertainty regarding the most appropriate radiation dose after incomplete resection. This analysis was performed to determine the optimal dose.


METHODS
All cases reported since 1982 were reviewed for age, gender, resection status, total dose, dose per fraction, local control, and overall survival. Additional data were obtained from the authors. The inclusion criteria were incomplete resection, postoperative irradiation, complete data, and 12 months' minimal follow-up. Two groups were formed according to the equivalent dose in 2-Gy fractions (EQD2): group A (40.0-53.6 Gy) and group B (54.0-62.2 Gy). Local control and survival were compared using Kaplan-Meier analysis and the log-rank test.


RESULTS
Eighty-nine patients (group A 42, group B 47) met the inclusion criteria. At 5 years, the local control rate was 98% for group B vs. 69% for group A. At 10 years, it was 89% vs. 65% (p = 0.0066). The 5- and 10-year survival rate was 98% for group B vs. 88% for group A (p = 0.1).


CONCLUSIONS
Our data suggest that a EQD2 > or =54 Gy significantly improves local control in patients with subtotally resected neurocytomas. Although the difference in survival was not significant, a trend toward better survival was noted after a EQD2 of > or =54 Gy.
Rades
Dirk
D
Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Germany. rades.dirk@gmx.net
Schild
Steven E
SE
Ikezaki
Kiyonobu
K
Fehlauer
Fabian
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018306:Neurocytoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D015996:Survival Rate; D013997:Time Factors