title: Long term outcome of adolescent and adult patients with pineal parenchymal tumors treated with fractionated radiotherapy between 1982 and 2003--a single institution's experience.
abstract: BACKGROUND
  To evaluate the effectivity of fractionated radiotherapy in adolescent and adult patients with pineal parenchymal tumors (PPT).
  
  
  METHODS
  Between 1982 and 2003, 14 patients with PPTs were treated with fractionated radiotherapy. 4 patients had a pineocytoma (PC), one a PPT with intermediate differentiation (PPTID) and 9 patients a pineoblastoma (PB), 2 of which were recurrences. All patients underwent radiotherapy on the primary tumor site with a median total dose of 54 Gy. In 9 patients with primary PB treatment included whole brain irradiation (3 patients) or irradiation of the craniospinal axis (6 patients) with a median total dose of 35 Gy.
  
  
  RESULTS
  Median follow-up was 123 months in the PC patients and 109 months in the patients with primary PB. 7 patients were free from relapse at the end of follow-up. One PC patient died from spinal seeding. Among 5 PB patients treated with radiotherapy without chemotherapy, 3 developed local or spinal tumor recurrence. Both patients treated for PB recurrences died. The patient with PPTID is free of disease 7 years after radiotherapy.
  
  
  CONCLUSIONS
  Local radiotherapy seems to be effective in patients with PC and some PPTIDs. Diagnosis and treatment of patients with more aggressive variants of PPTIDs as well as treatment of PB needs to be further improved, since local and spinal failure even despite craniospinal irradiation (CSI) is common. As PPT are very rare tumors, treatment within multi-institutional trials remains necessary.
authors.affiliation: Department of Radiation Oncology, University Hospital Heidelberg, INF 400, 69120 Heidelberg, Germany. eva.stoiber@med.uni-heidelberg.de
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Stoiber
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schaible
authors.forename: Klaus
authors.initials: K
authors.lastname: Herfarth
authors.forename: Daniela
authors.initials: D
authors.lastname: Schulz-Ertner
authors.forename: Peter E
authors.initials: PE
authors.lastname: Huber
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
authors.forename: Susanne
authors.initials: S
authors.lastname: Oertel
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010870:Pineal Gland / Q000473:pathology* / Q000528:radiation effects; D010871:Pinealoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000453:epidemiology; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult