Intraventricular neurocytomas: a systematic review of stereotactic radiosurgery and fractionated conventional radiotherapy for residual or recurrent tumors.
To determine optimal treatment for recurrent or residual intraventricular neurocytomas (IVNs), a systematic review of PubMed and EMBASE was conducted comparing fractionated conventional radiotherapy (FCRT) versus stereotactic radiosurgery (SRS). Inclusion criteria included histological IVN documentation, at least 6 months of follow-up observation and described dose of FCRT or SRS administered. Descriptive statistical and Kaplan-Meier analyses were performed. The literature search yielded 451 articles. Sixteen studies met inclusion criteria. The local tumor control proportion was 93% and 88% in the SRS and FCRT subgroups, respectively. The relative risk (RR) of local recurrence was 0.57 less (95% CI: 0.21-1.57; log-rank p=0.85) and the RR of all-cause mortality was 0.23 less (95% CI: 0.05-1.05; log-rank p=0.22) in SRS subgroup compared to the FCRT subgroup but did not reach statistical significance. Recurrence was significantly associated with presence of histological atypia (log-rank p<0.001). Severe complications were lower in SRS subgroup (5.5% versus 7.5%, p=0.74); however, distant tumor recurrence was slightly lower in the FCRT subgroup (1.5% versus 5.5%, p=0.24). The role of SRS or FCRT in the management of residual or recurrent IVNs will continue to depend on the balance between the risks and benefits of SRS and FCRT until better quality data are available.
University of California, Berkeley Department of Epidemiology, 101 Haviland Hall, Berkeley 94720, USA; Department of Neurosurgery, University of California, San Francisco, 505 Parnassus Avenue, Room M779, San Francisco 94143-0112, USA. Electronic address: roxannamelissa.garcia@ucsf.edu.
Roxanna M
RM
Garcia
Department of Neurosurgery, University of California, San Francisco, 505 Parnassus Avenue, Room M779, San Francisco 94143-0112, USA.
Michael E
ME
Ivan
Department of Neurosurgery, University of California, San Francisco, 505 Parnassus Avenue, Room M779, San Francisco 94143-0112, USA.
Taemin
T
Oh
Department of Radiation Oncology, University of California, San Francisco, 505 Parnassus Avenue, Room L-08, San Francisco 94143-0226, USA.
Igor
I
Barani
Department of Neurosurgery, Northwestern University, 676 N. St. Clair Street, Suite 2210, Chicago 60611, USA. Electronic address: aparsa@nmff.org.
Andrew T
AT
Parsa
D002551:Cerebral Ventricle Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000601:surgery; D018365:Neoplasm, Residual / Q000532:radiotherapy / Q000601:surgery; D018306:Neurocytoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D011874:Radiometry; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome
Central neurocytoma; Intraventricular neurocytoma; Radiosurgery; Radiotherapy; Systematic review