gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Pineal-parenchymal tumors: Management with sterotactic 125Iodine brachytherapy

Meeting Abstract

  • Faycal El Majdoub - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität zu Köln, Deutschland
  • Christian Bührle - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität zu Köln, Deutschland
  • Martin Kocher - Klinik für Strahlentherapie, Universität zu Köln, Deutschland
  • Stefan Hunsche - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität zu Köln, Deutschland
  • Harald Treuer - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität zu Köln, Deutschland
  • Volker Sturm - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität zu Köln, Deutschland
  • Mohammad Maarouf - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Universität zu Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1559

DOI: 10.3205/10dgnc036, URN: urn:nbn:de:0183-10dgnc0362

Published: September 16, 2010

© 2010 El Majdoub et al.
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Outline

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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 to 68 years, median age 34 years) with pineal parenchymal tumors (8 pineocytomas, 10 malignant PPTs) were treated at our institution with interstitial radiosurgery using stereotactically guided iodine-125 seed implantation (125I-IRS) as either primary or salvage therapy. The cumulative tumor surface dose ranged from 40 to 64 Gy. Adjuvant radiotherapy of the whole brain or the craniospine was done in patients with grade III and grade IV PPT. The median follow-up period was 57.4 months (range 6 to 134 months).

Results: Overall actuarial 5- and 8-year survival rates after IRS were 100% and 86% for pineocytomas, and the overall actuarial 5-year survival rate was 78% for high-grade PPTs. Follow-up MRI showed complete remission in 72% (13/18) and partial remission in 28% (5/18) of the cases. One patient developed an out-of-field relapse, 4 years after partial remission of a pineocytoma, which have also been treated with IRS. There was no treatment-related mortality. Treatment related morbidity occurred in two patients.

Conclusions: This study indicates that stereotactic 125I-IRS for the management of PPTs is quite efficient and safe. Due to the low rate of side effects, IRS may develop into 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.