Leksell Gamma Knife treatment for pilocytic astrocytomas: long-term results

Šimonová, Gabriela; Kozubíková, Petra; Novotný, Josef

doi:10.3171/2015.10.peds14443

Cited by 22 publications

(4 citation statements)

References 33 publications

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“…Simonova et al [ 44 ] assessed long-term outcomes with GK-based stereotactic irradiation for PA. Their series included 25 pediatric patients with a median age of 13 years (range: 3-17 years). Median target volume was 2.7 cc (range: 0.2-25 cc).…”

Section: Radiosurgery For Pamentioning

confidence: 99%

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Concise review of radiosurgery for contemporary management of pilocytic astrocytomas in children and adults

Sager¹,

Dincoglan²,

Demiral³

et al. 2022

WJEM

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Pilocytic astrocytoma (PA) may be seen in both adults and children as a distinct histologic and biologic subset of low-grade glioma. Surgery is the principal treatment for the management of PAs; however, selected patients may benefit from irradiation particularly in the setting of inoperability, incomplete resection, or recurrent disease. While conventionally fractionated radiation therapy has been traditionally utilized for radiotherapeutic management, stereotactic irradiation strategies have been introduced more recently to improve the toxicity profile of radiation delivery without compromising tumor control. PAs may be suitable for radiosurgical management due to their typical appearance as well circumscribed lesions. Focused and precise targeting of these well-defined lesions under stereotactic immobilization and image guidance may offer great potential for achieving an improved therapeutic ratio by virtue of radiosurgical techniques. Given the high conformality along with steep dose gradients around the target volume allowing for reduced normal tissue exposure, radiosurgery may be considered a viable modality of radiotherapeutic management. Another advantage of radiosurgery may be the completion of therapy in a usually shorter overall treatment time, which may be particularly well suited for children with requirement of anesthesia during irradiation. Several studies have addressed the utility of radiosurgery particularly as an adjuvant or salvage treatment modality for PA. Nevertheless, despite the growing body of evidence supporting the use of radiosurgery, there is need for a high level of evidence to dictate treatment decisions and establish its optimal role in the management of PA. Herein, we provide a concise review of radiosurgery for PA in light of the literature.

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Section: Radiosurgery For Pamentioning

confidence: 99%

“…Patients with a planning target volume of 2.7 cc or less had increased PFS. Authors concluded that radiosurgery offers an alternative treatment modality, providing long term local control for management of small residual or recurrent PAs[ 44 ].…”

Section: Radiosurgery For Pamentioning

confidence: 99%

Concise review of radiosurgery for contemporary management of pilocytic astrocytomas in children and adults

Sager¹,

Dincoglan²,

Demiral³

et al. 2022

WJEM

View full text Add to dashboard Cite

show abstract

“…treatments, but the majority are single‐session radiosurgery procedures. Complication rates are low and consist mainly of transient radiation‐induced edema 1‐5 and reversible enlargement of tumor‐associated cysts 2 . Radiosurgery in the un‐resected population may be supported by the lower integral dose delivered to the brain using conventional intensity‐modulated radiation therapy (IMRT)‐based conformal therapy 6 …”

Section: Radiosurgerymentioning

confidence: 99%

Radiosurgery, reirradiation, and brachytherapy

Prasad

Vern-Gross

Wolden

2021

Pediatric Blood & Cancer

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Radiosurgery and brachytherapy are potentially useful treatment techniques that are sparingly applied in pediatric oncology. They are often used in the setting of reirradiation for recurrent or metastatic tumors. Reirradiation in children with recurrent tumors is complicated by the tolerance of critical organs and the potential risks for overall long‐term dose‐dependent complications. We review the current literature available in support of reirradiation and the use of radiosurgery and brachytherapy in pediatric patients.

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“…Эффективность СРХ, по мнению большинства авторов, не вызывает сомнений. Однако на данный момент публикации о проведении СРХ по поводу ПА немногочисленны, а количество наблюдений в этих работах невелико [10][11][12][13][14][15][16][17].…”

Section: Introductionunclassified

Radiosurgical treatment of patients with intracranial pilocytic astrocytomas

Trunin

Golanov

Konovalov

et al. 2021

Nejrohirurgiâ (Mosk.)

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The study objective is to assess the outcomes after stereotactic radiosurgical treatment (SRS) in patients with pilocytic astrocytomas after non-radical surgery and after continued tumor growth.Materials and methods. The report includes 56 patients (37 males and 19 females) who have undergone SRS in N. N. Burdenko National Medical Research Center of Neurosurgery from March 2005 to January 2018.Results. The majority of patients (75 %) were children. Almost 43 % of patients underwent SRS as part of the primary treatment after biopsy or incomplete removal, other patients – in the event of continued tumor growth after non-total surgery. Tumors involved the cerebellum (41 %), brainstem (23 %), thalamus (19.6 %) and cerebral hemispheres (16.1 %). The median tumor volume was 1.9 cm3 (0.14–19.00 cm3), 23 % of patients had cysts in the tumor. The prescribed dose was 12 to 22 Gy (median 18 Gy) over 50–80 % isodose line. The follow-up was available for 54 (96.4 %) patients. The median follow-up was 67 months (3–151 months). All patients were alive at the end of the follow-up examination. In 14 (25 %) patients, the development of pseudo-progression (PSP) was noted. The median detection of PSP is 11 months (3–65 months). Of these, in 7 (50 %) patients PSP was accompanied by clinical deterioration: in 5 – an increase in general cerebral symptoms and in 1 patient – an episode and an increase in cerebellar symptoms. Eight (57 %) patients with PSP were reoperated: 4 underwent removal of the tumor, 4 – emptying of the cyst and placement of the Ommaya reservoir, which led to regression of the existing symptoms. No other toxicity was observed in patients. At the time of the completion of the follow-up examination (with a given median follow-up), no relapses were detected. There was no clinical deterioration after SRS.Conclusion. Radiosurgical treatment is an effective and safe method of radiation treatment for patients with primary pilocytic astrocytomas and recurrent pilocytic astrocytomas, providing control over tumor growth in all patients with a low risk of complications.

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Leksell Gamma Knife treatment for pilocytic astrocytomas: long-term results

Cited by 22 publications

References 33 publications

Concise review of radiosurgery for contemporary management of pilocytic astrocytomas in children and adults

Concise review of radiosurgery for contemporary management of pilocytic astrocytomas in children and adults

Radiosurgery, reirradiation, and brachytherapy

Radiosurgical treatment of patients with intracranial pilocytic astrocytomas

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