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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

  • Case study
  • Published:
Strahlentherapie und Onkologie Aims and scope Submit manuscript

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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Conflict of interest

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

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Authors and Affiliations

  1. Zentrum für Radiochirurgie und Präzisionsbestrahlung, Klinikum der J.W. Goethe Universität Frankfurt am Main, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany

    R. Wolff, A. Mack & R. Heyd

  2. Klinik und Poliklinik für Neurochirurgie, Klinikum der J.W. Goethe Universität Frankfurt am Main, Frankfurt am Main, Germany

    V. Seifert

  3. Klinik für Strahlentherapie und Onkologie, Klinikum der J.W. Goethe Universität Frankfurt am Main, Frankfurt am Main, Germany

    C. Rödel

  4. Institut für Neuroonkologie, Klinikum der J.W. Goethe Universität Frankfurt am Main, Frankfurt am Main, Germany

    J. Steinbach

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  1. R. Wolff
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  2. V. Seifert
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  3. A. Mack
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  4. J. Steinbach
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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

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