Gamma knife surgery for pineal region tumors: an alternative
          strategy for negative pathology

Wang, Peng; Mao, Qing; Wang, Wei; Zhou, Liang-Xue; Liu, Yan-Hui

doi:10.1590/0004-282X20130217

Acessibilidade / Reportar erro

Brasil

Arquivos de Neuro-Psiquiatria

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Articles • ANPArq. Neuro-Psiquiatr. 72 (2) • Feb 2014 • https://doi.org/10.1590/0004-282X20130217 copy

Gamma knife surgery for pineal region tumors: an alternative strategy for negative pathology

Cirurgia com gamma knife como tratamento experimental para tumores da região da pineal: uma estratégia alternativa quando os dados anatomopatológicos são negativos

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

: Pineal region tumors (PRTs) are uncommon, and treatments vary among neoplasm types. The authors report their experience with gamma knife surgery (GKS) as an initial treatment in a series of PRT patients with unclear pathological diagnoses.

Method

: Seventeen PRT patients with negative pathology who underwent GKS were retrospectively studied. Nine patients had further whole-brain and spinal cord radiotherapy and chemotherapy 6–9 months after GKS.

Results

: Sixteen of 17 cases were followed up over a mean of 33.3 months. The total response rate was 75%, and the control rate was 81.3%. No obvious neurological deficits or complications were attributable to GKS.

Conclusion

: The findings indicate that GKS may be an alternative strategy in selected PRT patients who have negative pathological diagnoses, and that good outcomes and quality of life can be obtained with few complications.

gamma knife surgery; pineal region tumors; radiosurgery

Case No.	Age, sex	Treatment	AFP, β-HCG^†	Mean diameter	Marginal dose	Isodose line	Duration of clinical FU	Response	Complications/or death
1	27, M	VPS, GKS, Chemo, WBSRT	(-), (-)	2.1 cm	13 Gy	50%	56 mos	CR at 56 mos	None
2	16, M	VPS, GKS, Chemo, WBSRT	(-), (+)	1.8 cm	13 Gy	50%	30 mos	PR at 30 mos	None
3	12, M	VPS, GKS, Chemo, WBSRT	(-), (-)	1.1 cm	13 Gy	50%	61 mos	CR at 61 mos	None
4	21, M	VPS, GKS, Chemo, WBSRT	(-), (-)	2.5 cm	13 Gy	50%	25 mos	CR at 25 mos	None
5	20, M	VPS, GKS, Chemo, WBSRT	(-), (-)	3.6 cm	13 Gy	45%	64 mos	CR at 64 mos	None
6	16, M	VPS, GKS, Chemo, WBSRT	(-), (+)	3.0 cm	14 Gy	45%	15 mos	CR at 15 mos	None
7	31, M	VPS, GKS, Chemo, WBSRT	(-), (-)	1.3 cm	15 Gy	50%	60 mos	PR at 60 mos	None
8	18, M	VPS, GKS, Chemo, WBSRT	(-), (-)	1.6 cm	14.5 Gy	50%	32 mos	CR at 32 mos	None
9	45, M	GKS, Chemo, WBSRT	(-), (+)	2.3 cm	15 Gy	50%	9 mos	PG at 9 mos with VSS	Died 9 mos after GKS with ISS
10	65, F	VPS, GKS	(-), (+)	2.2 cm	13 Gy	50%	43 mos	CR at 43 mos	None
11	13, M	VPS, GKS	(+), (-)	2.4 cm	13 Gy	45%	18 mos	PG at 18 mos	Died 18 mos after GKS
12	54, M	VPS, GKS	(-), (-)	1.5 cm	15 Gy	50%	16 mos	CR at 16 mos	None
13	34, M	VPS, GKS	(-), (-)	1.6 cm	14 Gy	50%	39 mos	CR at 39 mos	None
14	16, M	VPS, GKS	(+), (+)	2.0 cm	13 Gy	50%	2 mos	PG at 2 mos	Died 2 mos after GKS
15	18, M	GKS	(+), (-)	3.1 cm	15 Gy	50%	35 mos	PR at 35 mos	None
16	13, M	GKS	(-), (-)	2.9 cm	13 Gy	45%	Lost	Lost	Lost
17	14, F	GKS	(-), (+)	2.4 cm	14 Gy	45%	28 mos	NC at 28 mos	None

Response	No. of cases	Percentage
CR	9	56.3%
PR	3	18.8%
MR	0	0.0%
NC	1	6.3%
PG	3	18.8%
Total response rate	12	75.0%
Control rate	13	81.3%
Total no. of cases	16	100%

Reponses	AFP/β-HCG in serum
	GKS, Chemo, WBSRT		GKS
	-/-	+/-, -/+, +/+	-/-	+/-, -/+, +/+
CR	5	1	2	1
PR	1	1	0	1
MR	0	0	0	0
NC	0	0	0	1
PG	0	1	0	2
No. of cases	6	3	2	5

Academia Brasileira de Neurologia - ABNEURO R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices Torre Norte, 04101-000 São Paulo SP Brazil, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revista.arquivos@abneuro.org

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence
: Yan-Hui Liu; Department of Neurosurgery, West China Hospital, Sichuan University, 37# Guoxue Alley, Chengdu, 610041 China; E-mail: liuyanhui9@gmail.com