Radiosurgery for central neurocytoma: long-term outcome and failure pattern.
Despite the favorable outcomes of radiosurgery for central neurocytoma (CN), these results are based on case series that included a limited number of patients and short follow-up periods because of the scarcity of CN. Because CN is a benign tumor with an indolent clinical course, long-term follow-up and analysis of failure pattern are required for the establishment of the role of radiosurgery in the management of CN. Twenty consecutive patients (10 patients who received Gamma Knife radiosurgery (GKRS) as a primary treatment and 10 patients who received GKRS as a secondary treatment) with a radiological follow-up period ≥36 months were included in this study. The mean radiological follow-up duration was 100 months (range 43-149 months). The mean tumor volume was 10.4 cm(3) (range 0.4-36.4 cm(3)) and the mean marginal dose was 15.4 Gy (range 9-20 Gy). Local control failure was found in six patients at the last radiological follow-up. Overall actuarial local control rates were 89.5 % at 5 years and 83.1 % at 10 years. The primary GKRS group included two cases with local failure, with cyst formation or local recurrence. In contrast, in the secondary GKRS group, local control failure was found in four cases (including three cases with an "out-of-field recurrence" pattern) and occurred earlier compared with the primary GKRS group. Our study suggests that GKRS could be a primary or secondary treatment option for CN. However, long-term radiological follow-up is mandatory. In particular, more careful consideration during margin delineation and planning procedure is required in the secondary GKRS group.
Department of Neurosurgery, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 110-744, Korea.
Jin Wook
JW
Kim
Dong Gyu
DG
Kim
Hyun-Tai
HT
Chung
Seung Hong
SH
Choi
Jung Ho
JH
Han
Chul-Kee
CK
Park
Chae-Yong
CY
Kim
Sun Ha
SH
Paek
Hee-Won
HW
Jung
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000209:etiology*; D018306:Neurocytoma / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D016634:Radiosurgery; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult