Boost Gamma Knife surgery during multimodality management of adult medulloblastoma

Germanwala, Anand V.; Jeffrey, C.; Tomycz, Nestor D.; Niranjan, Ajay; Flickinger, John C.; Kondziolka, Douglas; Lunsford, L. Dade

doi:10.3171/jns/2008/108/2/0204

Cited by 26 publications

(9 citation statements)

References 16 publications

(13 reference statements)

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“…Only one spinal recurrence was observed after our postoperative treatment. This result is not consistent with other adult medulloblastoma series [2,27,39,44].…”

Section: Discussioncontrasting

confidence: 79%

The role of radiotherapy in adult medulloblastoma: long-term single-institution experience and a review of the literature

Boccadoro¹,

Chiesa²,

Chieffo

et al. 2011

J Neurooncol

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Medulloblastoma (MB) occurs infrequently in adult patients and standard treatment is still controversial. We report our long-term, single-institution experience of adult MB and a review of the literature. We analysed adult patients with histologically proved MB treated by postoperative radiotherapy. Primary endpoints were local control (LC), disease-free survival (DFS), and overall survival (OS). Acute toxicity was reported according to CTC-NCI score vers. 3.0 and specific neuropsychological assessment analysis was performed to define late brain toxicity. From 1990-2008, 13 patients were treated by craniospinal (CSI, 12/13) or cranial irradiation (1/13, because of bad clinical conditions). Median follow up was 101 months (64-218). Complete radiological response was observed in 12/13 patients and a partial response in 1/13. Ten-year LC, OS, and DFS were 91, 76, and 84%, respectively. Two patients died because of local and spinal progression after 13 and 62 months. Acute G3 haematological toxicity (RTOG score) was observed for one patient only. The neuropsychological analysis did not reveal late toxicity related to brain radiotherapy. This experience confirms the efficacy and safety of radiotherapy in adult MB patients, resulting in very interesting 10-year LC and OS.

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“…Only one spinal recurrence was observed after our postoperative treatment. This result is not consistent with other adult medulloblastoma series [2,27,39,44].…”

Section: Discussioncontrasting

confidence: 79%

The role of radiotherapy in adult medulloblastoma: long-term single-institution experience and a review of the literature

Boccadoro¹,

Chiesa²,

Chieffo

et al. 2011

J Neurooncol

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“…They suggested that SRS could be considered as one treatment option for small, locally recurrent medulloblastomas [5]. Germanwala et al [18] reported the results of boosted GKS for adult medulloblastoma or supratentorial PNET during multimodal treatment. Four of 12 patients (33%) had tumor progression locally with or without intracranial metastases.…”

Section: Discussionmentioning

confidence: 99%

Gamma Knife Surgery for Recurrent or Residual Supratentorial Primitive Neuroectodermal Tumors

Bem

Kim²,

Kim

et al. 2016

Stereotact Funct Neurosurg

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Background: Supratentorial primitive neuroectodermal tumors (PNETs) are highly malignant and rare tumors of the central nervous system. Objectives: The aim of this study was to determine the role of Gamma Knife surgery (GKS) as a salvage treatment option for patients with recurrent or residual supratentorial PNETs. Methods: Between 1998 and 2014, 11 patients with supratentorial PNETs were retrospectively analyzed. This series consisted of 7 male and 4 female patients. The median age was 17 years. All patients received surgical resection followed by adjuvant therapy. The median time from operation to the first GKS treatment was 72.5 months. The median tumor volume was 17.5 cm³, and the median marginal dose was 11.5 Gy. Results: 15 (65%) of the 23 tumors had been controlled. The actuarial local tumor control rate was 91% at 3 months, 73% at 6 months, and 44% at 12 months. At the time of analysis, 9 (82%) of the patients had died. The median survival time after the first GKS session was 17 months. The median survival time from the initial diagnosis was 65 months. No adverse radiation effect after GKS treatment occurred in any patient. Conclusions: GKS treatment might be an effective salvage treatment option for recurrent or residual supratentorial PNETs after multimodal treatment.

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“…118 SRS demonstrated safety and efficacy in a small series of 12 adult patients with residual or recurrent disease. 119 …”

Section: Medulloblastoma and Supratentorial Primitive Neuroectodermalmentioning

confidence: 99%

Central Nervous System Cancers

Nabors

Ammirati

Bierman³

et al. 2013

J Natl Compr Canc Netw

107

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Primary and metastatic tumors of the central nervous system are a heterogeneous group of neoplasms with varied outcomes and management strategies. Recently, improved survival observed in 2 randomized clinical trials established combined chemotherapy and radiation as the new standard for treating patients with pure or mixed anaplastic oligodendroglioma harboring the 1p/19q codeletion. For metastatic disease, increasing evidence supports the efficacy of stereotactic radiosurgery in treating patients with multiple metastatic lesions but low overall tumor volume. These guidelines provide recommendations on the diagnosis and management of this group of diseases based on clinical evidence and panel consensus. This version includes expert advice on the management of low-grade infiltrative astrocytomas, oligodendrogliomas, anaplastic gliomas, glioblastomas, medulloblastomas, supratentorial primitive neuroectodermal tumors, and brain metastases. The full online version, available at NCCN.org, contains recommendations on additional subtypes.

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Boost Gamma Knife surgery during multimodality management of adult medulloblastoma

Cited by 26 publications

References 16 publications

The role of radiotherapy in adult medulloblastoma: long-term single-institution experience and a review of the literature

The role of radiotherapy in adult medulloblastoma: long-term single-institution experience and a review of the literature

Gamma Knife Surgery for Recurrent or Residual Supratentorial Primitive Neuroectodermal Tumors

Central Nervous System Cancers

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