Systematic Analysis of Clinical Outcomes Following Stereotactic Radiosurgery for Central Neurocytoma

Abstract

Central neurocytoma (CN) typically presents as an intraventricular mass causing obstructive hydrocephalus. The first line of treatment is surgical resection with adjuvant conventional radiotherapy. Stereotactic radiosurgery (SRS) was proposed as an alternative therapy for CN because of its lower risk profile. The objective of this systematic analysis is to assess the efficacy of SRS for CN. A systematic analysis for CN treated with SRS was conducted in PubMed. Baseline patient characteristics and outcomes data were extracted. Heterogeneity and publication bias were also assessed. Univariate and multivariate linear regressions were used to test for correlations to the primary outcome: local control (LC). The estimated cumulative rate of LC was 92.2% (95% confidence interval: 86.5-95.7%, p<0.001). Mean follow-up time was 62.4 months (range 3-149 months). Heterogeneity and publication bias were insignificant. The univariate linear regression models for both mean tumor volume and mean dose were significantly correlated with improved LC (p<0.001). Our data suggests that SRS may be an effective and safe therapy for CN. However, the rarity of CN still limits the efficacy of a quantitative analysis. Future multi-institutional, randomized trials of CN patients should be considered to further elucidate this therapy.

Tumor control of third ventricular central neurocytoma after gamma knife radiosurgery in an elderly patient

“…Central neurocytoma is rare neuroepithelial tumor that is usually located in intraventricular locations near the foramen of Monro. [1,15] Central neurocytomas usually occur in the lateral ventricle, with only 3% isolated to the third ventricle. [4] The previous literature report that these tumors are usually found in young adults, with a median age between 25 and 30 years.…”

“…Although standard treatment for central neurocytoma is complete surgical resection, it is difficult to remove the tumor completely because of its location. [15] Recent studies have suggested that stereotactic radiosurgery is an effective treatment modality because radiosurgery has the advantage of preserving normal brain tissues and delivering high doses of radiation to specified lesions compared with other radiotherapies. According to a recent systematic analysis, patients who underwent GKR alone had a survival rate of 98% at a mean follow-up of 62.4 months.…”

Uncommon low-grade brain tumors

“…In a series of 14 patients treated to a mean tumor margin dose of 12.1 Gy there was a mean reduction in tumor volume by 69% at 65 months with neither tumor recurrence nor radiotherapy toxicity. 59,60 In patients with recurrent disease not suitable for further surgery or radiotherapy, chemotherapy may be an option using combinations of platinum, etoposide, topotecan, and cyclophosphamide. 53…”

Transcortical approach to lateral ventricular central neurocytomas: a case series and review of the literature

“…On computed tomographies, CNs appear heterogeneously hyperdense with contrast enhancement while on magnetic resonance imaging; they are isointense on T1-weighted images and slightly hyperintense on T2-weighted images with vivid contrast enhancement [12]. These features may be confused with other intraventricular tumors especially ependymomas, oligodendrogliomas, and subependymal astrocytomas even after histopathology.…”

“…Surgical gross total resection is now considered the gold standard treatment for CNs that can be achieved in 30-50% of cases with a reported 99% 5-year survival rate that came down to 86% when subtotal resection was performed [5,7,12]. The proximity to the deep critical structures and high vascularity make the achievement of such goal a real challenge.…”