gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Pineal parenchymal tumors: management with interstitial 125Iodine radiosurgery

Interstitielle Jod-125-Radiochirurgie zur Behandlung von primären Pinealis-Tumoren

Meeting Abstract

  • corresponding author M. Maarouf - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität Köln
  • F. El Majdoub - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität Köln
  • J. Voges - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität Köln
  • R. Lehrke - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität Köln
  • M. Kocher - Abteilung für Bestrahlungs-Onkologie, Universität Köln
  • V. Sturm - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität Köln

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocFR.11.06

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Maarouf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: To evaluate the efficacy of interstitial radiosurgery (IRS) for pineal parenchymal tumors (PPTs).

Methods: 18 consecutive admitted patients (12 male and 6 female, age range 6–68 years, median age 34 years) with pineal parenchymal tumors (8 pineocytomas, 10 malignant PPTs) were treated at our institution with interstitial radiosurgery according to a prospective protocol using computer tomography (CT) and magnetic resonance imaging (MRI), and stereotactically guided iodine-125 seed implantation (125I-IRS) as either primary or salvage therapy. The cumulative tumor surface dose ranged from 40-64 Gy. Adjuvant fractionated radiotherapy of the whole brain or the craniospinal axis was applied in patients with grade III and grade IV PPT. The median follow-up periods from the time of diagnosis and the time of IRS were 76.5 resp. 57.4 months.

Results: Overall 5- and 8-year survival rates after IRS were 100% and 86% for pineocytomas and 78% and 78% for high-grade PPTs. Follow-up MRI showed complete remission in 72.2% (13/18) and partial remission in 27.8% (5/18) of the cases. One patient developed an out-of-field relapse 4 years after partial remission of a pineocytoma, which was already treated with IRS. Three patients died during follow-up: one due to extracranial tumor spread, one due to suicide, and the third of unknown cause. There was no treatment-related mortality. Morbidity related to treatment was documented in one patient (5.6%).

Conclusions: This study shows that stereotactic 125I-IRS for PPTs management is highly effective and safe. Because of its low rate of side effects, IRS may be an attractive alternative to microsurgery in de novo diagnosed pineocytomas. In malignant PPTs, IRS may be routinely applied in a multimodality treatment schedule supplementary to conventional irradiation.