Gamma Knife radiosurgery as primary treatment of low-grade brainstem gliomas: A systematic review and metanalysis of current evidence and predictive factors

Gagliardi, Filippo; Domenico, Pierfrancesco De; Snider, Silvia; Pompeo, Edoardo; Roncelli, Francesca; Barzaghi, Lina Raffaella; Bailo, Michele; Piloni, Martina; Spina, Alfio; Fodor, Andrei; Berzero, Giulia; Muzio, N. Di; Filippi, Massimo; Finocchiaro, Gaetano; Mortini, Pietro

doi:10.1016/j.critrevonc.2021.103508

Cited by 10 publications

(6 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The number of studies on GKRS for TPGs is particularly restricted. 22 Kihlstrom et al 6 reported 7 TPG cases treated with doses varying from 14 to 35 Gy. Most tumors responded well to treatment while severe radiation-induced edema and complications occurred in 2 patients with higher (35 Gy) marginal doses.…”

Section: Discussionmentioning

confidence: 99%

“…GKRS patients have more TRICs than studies involving RT, likely due to improved neuroimaging sensitivity. 22 Clinically significant TRICs are generally mild, often manifesting as temporary worsening of preexisting symptoms or emergence of transient disturbances, particularly related to gaze alterations caused by focal edema. 5,6 Similarly, one of our patients with pseudoprogression experienced transient Parinaud syndrome that resolved with steroid use.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Unveiling the Efficacy of Gamma Knife Radiosurgery for Tectal Plate Gliomas

Kilic Durankus,

Samanci,

Düzkalir

et al. 2023

Neurosurgery

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: Tectal plate gliomas (TPGs) are midbrain tumors that grow slowly and have a benign clinical course. Most TPGs are low-grade astrocytomas, but they can encompass various histological tumor types. Gamma Knife radiosurgery (GKRS) is being explored as a potentially safe and effective treatment option for TPGs, although research in this area is limited. This study aims to evaluate GKRS's efficacy and safety in patients with TPG and provide a comprehensive review of existing literature on the topic. METHODS: This retrospective, single-center study included 48 patients with consecutive TPG who underwent GKRS between September 2005 and June 2022. Patients diagnosed with TPGs based on radiological or tissue-based criteria and who had a minimum follow-up period of 12 months were eligible for inclusion. The primary end points were local control and the absence of GKRS-associated or tumor-associated mortality and morbidity. RESULTS: During a median follow-up of 28.5 months (range, 12-128), the radiological assessment showed tumor control in all cases, with 16.7% achieving a complete response and 68.8% achieving a partial response. Pseudoprogression occurred in 6.2% of cases, with onset ranging from 3 to 8 months. Clinical outcomes revealed no permanent neurological deterioration, with symptoms improving in 14.6% of patients and remaining stable in the others. One patient in the pseudoprogression group experienced transient Parinaud syndrome. One patient died during follow-up because of unrelated causes. The mean survival time after GKRS was 123.7 months. None of the clinical, radiological, or radiosurgical variables showed a correlation with partial/complete response, clinical improvement, or overall survival. CONCLUSION: There is limited research available on the management of TPGs, and this study presents the largest patient cohort treated with GKRS, along with a substantial follow-up duration. Despite its limitations, this study demonstrates the efficacy and low-risk profile of GKRS for TPGs.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Unveiling the Efficacy of Gamma Knife Radiosurgery for Tectal Plate Gliomas

Kilic Durankus,

Samanci,

Düzkalir

et al. 2023

Neurosurgery

View full text Add to dashboard Cite

show abstract

“…Concerns about the use RT as a first-line treatment relate to its possible sequelae, given the young age of the patients involved. There have been sporadic reports supporting the use of stereotactic radiosurgery (SRS) and Gamma Knife (GK), with a reported limit in the treatment of lesions extending to the cervical spine region [63][64][65]. Results from the literature show comparable results in terms of response to treatment when compared to standard RT which is more frequently associated with stable diseases [65].…”

Section: Discussionmentioning

confidence: 99%

“…There have been sporadic reports supporting the use of stereotactic radiosurgery (SRS) and Gamma Knife (GK), with a reported limit in the treatment of lesions extending to the cervical spine region [63][64][65]. Results from the literature show comparable results in terms of response to treatment when compared to standard RT which is more frequently associated with stable diseases [65]. When compared to RT, SRS and GK groups of patients show an apparent increase in the number of collateral minor adverse effects with major complications limited to few cases [65][66][67].…”

Section: Discussionmentioning

confidence: 99%

“…Results from the literature show comparable results in terms of response to treatment when compared to standard RT which is more frequently associated with stable diseases [65]. When compared to RT, SRS and GK groups of patients show an apparent increase in the number of collateral minor adverse effects with major complications limited to few cases [65][66][67]. New technological advances in SRS and GK techniques have been introduced during the years with promising results [68].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cervicomedullary Gliomas in Pediatric Age: A Systematic Review of the Literature and Tertiary Care Center Experience

et al. 2022

View full text Add to dashboard Cite

Introduction. CMG are usually low-grade tumors often found in pediatric age. Histological findings, treatments and classification have been much the same for 40 years, although histological and molecular classifications have largely been developed for other pediatric CNS tumors. The management and treatment of pediatric CMG is still conducted by many authors according to their anatomical location and characteristics, independently from histology. Methods. We conducted a literature review in PubMed (Medline) to identify relevant contributions about pediatric CMG published until December 31st, 2021. We also analyzed a series of 10 patients with CMG treated from 2006 to 2021 at IRCCS Istituto Nazionale dei Tumori. The aim of the present review is to see whether and how the diagnosis, treatment and classification of cervicomedullary gliomas (CMG) in children have developed over time, especially in the context of molecular advancements, and to analyze our single center experience in the last 15 years. Results. Thirty articles have been included in the review. Articles have been divided in two historical periods (1981-2000 and 2001-2021) and data from different series were analyzed to see how much the management and treatment of pediatric CMG have changed during years. Analysis of our series of 10 patients affected by CMG was also performed to compare it with the literature. Discussion. Management and classification of CMG in children has not dramatically changed during years. However, new insight from molecular diagnostics and target therapies and development of radiological, neurophysiological and radiotherapy techniques have updated treatment modalities in the last 20 years. Treatment modalities and their innovations have been reviewed and discussed. Further studies are needed to standardize and customize treatment protocols for these tumors.

show abstract

Tectal Glioma

Abdelaziz

Salles

2023

NeuroRadiosurgery: Case Review Atlas

View full text Add to dashboard Cite

Gamma Knife radiosurgery as primary treatment of low-grade brainstem gliomas: A systematic review and metanalysis of current evidence and predictive factors

Cited by 10 publications

References 35 publications

Unveiling the Efficacy of Gamma Knife Radiosurgery for Tectal Plate Gliomas

Unveiling the Efficacy of Gamma Knife Radiosurgery for Tectal Plate Gliomas

Cervicomedullary Gliomas in Pediatric Age: A Systematic Review of the Literature and Tertiary Care Center Experience

Tectal Glioma

Contact Info

Product

Resources

About