title: Role of radiosurgery in the management of pineal region tumours: indications, method, outcome.
abstract: Numerous tumour types can occur in the pineal region. Because these tumours are uncommon and heterogeneous, it is often difficult to establish optimal treatment strategies based on comparative clinical trials. To date, the role of radiosurgery for the treatment of pineal region tumours remains controversial. This report of a 10-year single-department experience and review of the literature focuses on the spectrum of pathologic features found in these pineal parenchymal tumours and on the interest of radiosurgery in their management. Considering pineocytomas, although these tumours have been considered to be radioresistant to fractionated radiotherapy, our results are in agreement with similar results reported in the literature in suggesting that radiosurgery may be an alternative to surgical resection or an adjuvant therapy when the resection is not optimal. When dissemination occurs after radiosurgery, however, craniospinal radiation and chemotherapy are necessary. Radiosurgery has also proven its interest in the treatment of germinomas as an alternative to encephalic radiotherapy with limited long-term damage. Regarding the other pathologies, radiosurgery can be considered as part of a multimodal treatment including surgery, chemo-radiotherapy and its role still has to be clearly defined.
authors.affiliation: Service de neurochirurgie, centre Gamma-Knife, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur Emile-Laine, 59037 Lille, France; Service de neurochirurgie, CHU de Caen, 14000 Caen, France. Electronic address: balossier-a@chu-caen.fr.
authors.forename: A
authors.initials: A
authors.lastname: Balossier
authors.affiliation: Service de neurochirurgie, centre Gamma-Knife, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur Emile-Laine, 59037 Lille, France. Electronic address: serge.blond@chru-lille.fr.
authors.forename: S
authors.initials: S
authors.lastname: Blond
authors.affiliation: Service de neurochirurgie, centre Gamma-Knife, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur Emile-Laine, 59037 Lille, France.
authors.forename: G
authors.initials: G
authors.lastname: Touzet
authors.affiliation: Service de radiothérapie, centre Oscar-Lambret, CHRU de Lille, 59037 Lille, France.
authors.forename: T
authors.initials: T
authors.lastname: Sarrazin
authors.affiliation: Service de radiothérapie, centre Oscar-Lambret, CHRU de Lille, 59037 Lille, France.
authors.forename: E
authors.initials: E
authors.lastname: Lartigau
authors.affiliation: Service de neurochirurgie, centre Gamma-Knife, hôpital Roger-Salengro, CHRU de Lille, rue du Professeur Emile-Laine, 59037 Lille, France.
authors.forename: N
authors.initials: N
authors.lastname: Reyns
mesh_terms: D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010870:Pineal Gland / Q000601:surgery*; D010871:Pinealoma / Q000628:therapy*; D016634:Radiosurgery / Q000379:methods; D015173:Supratentorial Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
keywords: Germ cell tumour; Pineal tumour; Pineoblastoma; Pineocytoma; Pinéaloblastome; Pinéalocytome; Radiochirurgie; Radiosurgery; Tumeur de la région pinéale; Tumeur germinale