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Gamma knife radiosurgery of recurrent atypical neurocytoma

Case report and review of the literature

Gamma-Knife-Radiochirurgie beim Rezidiv eines atypischen Neurozytoms

Fallbericht und Literaturübersicht

Abstract

Background and purpose

The goal of this work was to demonstrate the efficacy of stereotactic gamma knife radiosurgery (GKRS) for the treatment of neurocytoma by means of a case report and a comprehensive literature review.

Case report

A locally recurrent atypical neurocytoma in the area of the left third ventricle thalamic wall occurring 7 years after primary microsurgical resection in a 59-year old woman was treated by GKRS. A marginal dose of 17 Gy was delivered to the surrounding 50% isodose. At the last follow-up, 82 months after radiosurgery, the tumor was locally controlled. For the literature review, computerized bibliographic searches of Pubmed were supplemented with hand searches of reference lists and abstracts of ASCO/ASTRO/ESTRO meetings.

Discussion

The present case confirms the results of the literature analysis. From 1997–2011, a total of 14 series were published providing results of GKRS in 86 patients (89 lesions). The marginal doses, which have been applied, ranged from 9.6–20.0 Gy. With median follow-up intervals between 6 and 185 months, local control was 97.2% and local tumor progression of neurocytoma after GKRS was restricted to only 4 cases. In accordance with our own experience, GKRS was not associated with a relevant early or late toxicity.

Conclusion

GKRS can be assumed to be a safe and effective treatment modality of recurrent or residual neurocytoma.

Zusammenfassung

Hintergrund und Ziel

Ziel der Arbeit war es die Effektivität der stereotaktischen Gamma-Knife-Radiochirurgie zur Behandlung von Neurozytomen anhand eines Fallberichts und einer umfassenden Literaturübersicht darzustellen.

Fallbericht

Bei einer 59-jährigen Patientin trat 7 Jahre nach primärer mikrochirurgischer Resektion ein Lokalrezidiv eines atypischen Neurozytoms im Bereich der thalamischen Begrenzung des dritten Ventrikels auf, das mit der Gamma-Knife-Technik radiochirurgisch behandelt wurde. Bezogen auf die 50%-Isodose wurde am Tumorrand eine Dosis von 17 Gy appliziert. Zum Zeitpunkt der letzten Nachuntersuchung, 82 Monate nach Abschluss der Therapie, war der Tumor lokal kontrolliert. Die Literaturübersicht beruht auf der rechnergestützten Recherche in elektronischen Literaturdatenbanken (Pubmed) und wird ergänzt durch die Auswertung der Zitatlisten und Kurzfassungen von Kongressbänden (ASCO-, ASTRO-, ESTRO-Tagungen).

Diskussion

Der hier vorgestellte Fall bestätigt die Daten einer Literaturübersicht. Zwischen 1997 und 2011 wurden 14 Arbeiten publiziert, in denen Ergebnisse von insgesamt 86 Patienten (89 Läsionen) mitgeteilt wurden, die mittels Gamma-Knife-Gerät radiochirurgisch behandelt worden waren. Die applizierten Randdosen variierten zwischen 9,6 Gy und 20,0 Gy. In den Nachbeobachtungszeiträumen mit einer Spannbreite von 6 bis 185 Monaten waren 97,2% der Fälle lokal kontrolliert und nur in 4 Fällen war eine Progression aufgetreten. In Einklang mit unseren eigenen Erfahrungen ist die Gamma-Knife-Radiochirurgie mit keiner relevanten Früh- oder Spättoxizität behaftet.

Schlussfolgerungen

Die Gamma-Knife-Radiochirurgie kann als eine schonende Therapieoption zur Behandlung von Lokalrezidiven oder postoperativem Residualgewebe von Neurozytomen betrachtet werden.

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References

  1. Anderson RC, Elder JB, Parsa AT et al (2001) Radiosurgery for treatment of recurrent central neurocytomas. Neurosurgery 48:1231–1237

    PubMed  CAS  Google Scholar 

  2. Astner ST, Theodorou M, Dobrei-Ciuchendea M et al (2010) Tumor shrinkage assessed by volumetric MRI in the long-term follow-up after stereotactic radiotherapy of meningeomas. Strahlenther Onko 186:423–429

    Article  Google Scholar 

  3. Bertalanffy A, Roessler K, Dietrich W et al (2001) Gamma knife radiosurgery of recurrent central neurocytomas. A preliminary report. J Neurol Neurosurg Psychiatry 70:489–493

    PubMed  Article  CAS  Google Scholar 

  4. Bertalanffy A, Roessler K, Koporek O et al (2005) Recurrent central neurocytomas. Cancer 104:135–142

    PubMed  Article  Google Scholar 

  5. Chen CL, Shen CC, Wang J et al (2008) Central neurocytoma: a clinical, radiological and pathological study of nine cases. Clin Neurol Neurosurg 110:129–136

    PubMed  Article  Google Scholar 

  6. Choudhari KA, Kaliaperumal C, Jain A et al (2009) Central neurocytoma: a multidisciplinary review. Br J Neurosurg 23:585–595

    PubMed  Article  Google Scholar 

  7. Cobery ST, Noren G, Friehs GM et al (2001) Gamma knife surgery for treatment of central neurocytomas. Report of four cases. J Neurosurg 94:327–330

    PubMed  Article  CAS  Google Scholar 

  8. Fokas E, Henzel M, Hamm K et al (2010) Radiotherapy for brain metastases from renal cell cancer: should whole-brain radiotherapy by added to stereotactic radiosurgery? Analysis of 88 patients. Strahlenther Onkol 186:210–217

    PubMed  Article  Google Scholar 

  9. Genc A, Bozkurt SU, Karabagli P et al (2011) Gamma knife radiosurgery for cranial neurocytomas. J Neurooncol 105:647–657

    PubMed  Article  Google Scholar 

  10. Hara M, Aoyagi M, Yamamoto M et al (2003) Rapid shrinkage of remnant central neurocytoma after gamma knife radiosurgery: a case report. J Neurooncol 62:269–273

    PubMed  Article  Google Scholar 

  11. Hassoun J, Gambarelli D, Grisoli F et al (1982) Central neurocytoma. An electron-microscopic study of two cases. Acta Neuropathol 56:151–156

    PubMed  Article  CAS  Google Scholar 

  12. Holy R, Piroth M, Pinkawa M et al (2011) Stereotactic body radiation therapy (SBRT) for treatment of adrenal gland metastases from non-small cell lung cancer. Strahlenther Onkol 187:245–251

    PubMed  Article  Google Scholar 

  13. Javedan SP, Manwaring K, Smith KA (2003) Treatment of posterior third ventricular central neurocytoma with endoscopic biopsy, endoscopic third ventriculostomy and stereotactic radiosurgery. Minim Invasive Neurosurg 46:165–168

    PubMed  Article  CAS  Google Scholar 

  14. Kim CY, Paek SH, Jeong SS et al (2007) Gamma knife radiosurgery for central neurocytoma: primary and secondary treatment. Cancer 110:2276–2284

    PubMed  Article  Google Scholar 

  15. Lawrence YR, Li XA, el Naga I et al (2010) Radiation dose-volume effects in the brain. Int J Radiat Oncol Biol Phys 76(3 Suppl):S20–27

    PubMed  Article  Google Scholar 

  16. Leenstra JL, Rodriguez FJ, Frechette CM et al (2007) Central neurocytoma: management recommendations based on a 35-year experience. Int J Radiat Oncol Biol Phys 67:1145–1154

    PubMed  Article  Google Scholar 

  17. Matsunaga S, Shuto T, Suenaga J et al (2010) Gamma knife radiosurgery for central neurocytomas. Neurol Med Chir (Tokyo) 50:107–113

    Article  Google Scholar 

  18. Meisner J, Meyer A, Polivka B et al (2010) Outcome of moderately dosed radiosurgery for limited brain metastases. Report of single center experience. Strahlenther Onkol 186:76–81

    PubMed  Article  Google Scholar 

  19. Monje ML, Palmer T (2003) Radiation injury and neurogenesis. Curr Opin Neurol 16:129–134

    PubMed  Article  Google Scholar 

  20. Paek SH, Shin HY, Kim JW et al (2010) Primary culture of central neurocytoma: a case report. J Korean Med Sci 25:798–803

    PubMed  Article  Google Scholar 

  21. Pollock BE, Stafford JL (2001) Stereotactic radiosurgery for recurrent central neurocytoma: case report. Neurosurgery 48:441–443

    PubMed  CAS  Google Scholar 

  22. Rades D, Fehlhauer F, Schild S et al (2003) Die Behandlung des zentralen Neurozytoms: eine Meta-analyse basierend auf den Daten von 358 Patienten. Strahlenther Onkol 179:213–218

    PubMed  Article  Google Scholar 

  23. Rades D, Schild SE (2006) Value of postoperative stereotactic radiosurgery and conventional radiotherapy for incompletely resected typical neurocytoma. Cancer 106:1140–1143

    PubMed  Article  Google Scholar 

  24. Rades D, Schild SE, Fehlhauer F (2004) Prognostic value of MIB-1 labeling index for central neurocytoma. Neurology 62:987–989

    PubMed  Article  Google Scholar 

  25. Rades D, Schild SE, Ikezaki K et al (2003) Defining the optimal dose of radiation after incomplete resection of central Neurocytoma. Int J Radiat Oncol Biol Phys 55:373–377

    PubMed  Article  Google Scholar 

  26. Schild SE, Scheithauer BW, Haddock MG et al (1997) Central neurocytomas. Cancer 15:790–795

    Article  Google Scholar 

  27. Sharma MC, Deb P, Sharma S et al (2006) Neurocytoma: a comprehensive review. Neurosurg Rev 29:270–285

    PubMed  Article  Google Scholar 

  28. Tyler-Kabara E, Kondziolka D, Flickinger JC et al (2001) Stereotactic radiosurgery for residual neurocytoma. Report of four cases. J Neurosurg 95:879–882

    PubMed  Article  CAS  Google Scholar 

  29. Yang GF, Wu SY, Zhang LJ et al (2009) Imaging findings of extraventricular neurocytoma: report of three cases and review ofthe literature. Am J Neuroradiol 30:581–585

    PubMed  Article  Google Scholar 

  30. Yarsagil MG, Ammon K von, Deimling A von et al (1992) Central neurocytoma: histopathological variants and therapeutic approach. J Neurosurg 76:32–37

    Article  Google Scholar 

  31. Yen CP, Sheehan J, Patterson G et al (2007) Gamma knife surgery for neurocytoma. J Neurosurg 107:7–12

    PubMed  Article  Google Scholar 

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The corresponding author states that there are no conflicts of interest.

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Correspondence to R. Wolff.

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Wolff, R., Seifert, V., Mack, A. et al. Gamma knife radiosurgery of recurrent atypical neurocytoma. Strahlenther Onkol 188, 707–711 (2012). https://doi.org/10.1007/s00066-012-0116-1

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  • DOI: https://doi.org/10.1007/s00066-012-0116-1

Keywords

  • Radiosurgery, gamma knife
  • Radiotherapy
  • Neurocytoma
  • Brain tumors
  • Review

Schlüsselwörter

  • Gamma-Knife-Radiochirurgie
  • Strahlentherapie
  • Neurozytom
  • Hirntumoren
  • Review