title: Papillary tumors of the pineal region: a novel therapeutic option-stereotactic 125iodine brachytherapy.
abstract: We evaluated the efficacy of interstitial brachytherapy (IBT) using (125)Iodine ((125)I) seeds for treatment of papillary tumors of the pineal region. Between September 2003 and September 2010, four patients (M/F = 2/2; median age, 57.3 years; range 29.2-69.1 years) with papillary tumors of the pineal region underwent IBT using (125)I seeds. Before brachytherapy two patients underwent endoscopic ventriculo-cisternotomy, because of occlusive hydrocephalus, and subsequent microsurgical resection was performed on one; three patients were primarily treated with IBT. Median tumor volume was 3.3 ml (range 1.6-4 ml), the tumor surface dose ranged between 50 and 65 Gy. For three patients the seeds were implanted permanently whereas one patient received temporary implants (28 days). The median follow-up time was 53.6 months (range 13-103.4 months). After brachytherapy, follow-up MR images revealed complete remission in one patient, partial remission in two, and stable disease in the remaining patient. Neurological status improved in all patients (reduced headache and nausea/vomiting for four patients; improvement of oculomotor dysfunction for two of three patients partially and for one of three patients completely). Neither treatment-related morbidity nor mortality was observed. Our results are indicative of good local control of papillary tumors of the pineal region after IBT, without treatment-related morbidity.
authors.affiliation: Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Kerpenerstrasse 62, 50937, Cologne, Germany. faycal.el-majdoub@uk-koeln.de
authors.forename: Faycal
authors.initials: F
authors.lastname: El Majdoub
authors.forename: Tobias
authors.initials: T
authors.lastname: Blau
authors.forename: Mauritius
authors.initials: M
authors.lastname: Hoevels
authors.forename: Christian
authors.initials: C
authors.lastname: Bührle
authors.forename: Martina
authors.initials: M
authors.lastname: Deckert
authors.forename: Harald
authors.initials: H
authors.lastname: Treuer
authors.forename: Volker
authors.initials: V
authors.lastname: Sturm
authors.forename: Mohammad
authors.initials: M
authors.lastname: Maarouf
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D002291:Carcinoma, Papillary / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D010870:Pineal Gland / Q000473:pathology*; D010871:Pinealoma / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D007457:Iodine Radioisotopes