Abstract
The role of gamma knife radiosurgery as an additional therapy after conventional treatments for pineal and related tumors was studied in 30 of 33 tumors with a mean follow-up of 23.3 months. Overall results showed that a complete response was obtained in 8 cases (26.7%) and the response rate was 73.3%. However, tumor progression was found in 8 cases (26.7%), of whom 7 (23.3%) died as a consequence. Germinoma and pineocytoma showed higher response and control rates (100%), and neither progression nor death occurred after gamma knife treatment. Germinoma with syncytiotrophoblastic giant cells (STGC) has been thought to have an intermediate prognosis. Two of our cases showed a partial response and another progression. Malignant germ cell tumor and pineoblastoma showed unfavorable responses and prognosis, with the response and progression rates both being 50%.
Gamma knife radiosurgery was the initial treatment in three pineal tumor cases without a histological diagnosis, and one complete and two partial responses were obtained.
Gamma knife radiosurgery is expected to be an effective and novel approach to pineal and related tumors, not only as an adjuvant but also as an initial treatment.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Comittee of Brain Tumor Registry of Japan: The Criteria of Evaluation of the Effects of Treatments for Brain Tumors. Kanehara Publisher Co, Japan, 1995
Comittee of Brain Tumor Registry of Japan: Brain Tumor Registry of Japan, Vol 7, p 56, 1990
Matsutani M, Sano K, Takakura K, Fujimaki T, Nakamura O: Combined treatment with chemotherapy and radiation therapy for intracranial germ cell tumors. Childs Nerv Syst 14: 59–62, 1998
Ogawa K, Toita T, Kakinohana Y, Yamaguchi K, Miyagi K, Kinjyo T, Yamashiro K, Sawada S: Radiation therapy for intracranial germ cell tumors; predictive value of tumor response as evaluated by computed tomography. Int J Clin Oncol 2: 67–72, 1997
Dempsy PK, Kondziolka D, Lunsford LD: Stereotactic diagnosis and treatment of pineal region tumors and vascular malformations. Acta Neurochir (Wien) 116: 14–22, 1992
Regine WF, Hodes JE, Patchel RA: Intracranial germinoma: Treatment with radiosurgery alone - A case report. J Neuro-Oncol 37: 75–77, 1998
Casentini L, Colombo F, Pozza F, Benedetti A: Combined radiosurgery and external radiotherapy of intracranial germinomas. Surg Neurol 34: 79–86, 1990
Akai T, Iizuka H, Kadoya S, Nojima T: Extraneural metastasis of intracranial germinoma with syncytiotrophoblastic giant cell - case report. Neurol Med Chir (Tokyo) 38: 574–577, 1998
Kida Y, Kobayashi T, Yoshida J, Kato K, Kageyama N: Chemotherapy with cysplatin for AFP-secreting germ cell tumors of the central nervous system. J Neurosurg 65: 470–475, 1986
Kobayashi T, Yoshida, Ishiyama J, Noda S, Kita A, Kida Y: Combination chemotherapy with cisplatin and etoposide for malignant intracranial germ-cell tumors. J Neurosurg 70: 676–681, 1988
Subach BR, Lunsford LD, Kondziolka D: Stereotactic radiosurgery in the treatment of pineal region tumors. In: Lunsford LD, Kondziolka D, Flickinger JC (eds) Gamma Knife Surgery. Basel, Karger, Prog Neurol Surg, Vol 14, 1998 pp 175–194
Fauchon F, Jouvet A, Paquis P, Saint-Pierre G, Mottolese C, Ben Hassel M, Chauveinc L, Sichez JP, Philippon J, Schlienger M, Bouffet E: Parenchymal pineal tumors: a clinicopathological study of 76 cases. Int J Rad Oncol Biol Phys 46: 959–968, 2000
Backlund EO, Rahn T, Sorby B: Treatment of pinealomas by stereotactic radiation surgery. Acta Radiol (Ther) 13: 368–376, 1974
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kobayashi, T., Kida, Y. & Mori, Y. Stereotactic gamma radiosurgery for pineal and related tumors. J Neurooncol 54, 301–309 (2001). https://doi.org/10.1023/A:1012727306066
Issue Date:
DOI: https://doi.org/10.1023/A:1012727306066