Nsrg-17. Gamma Knife Radiosurgery for the Treatment of Grade I and Ii Astrocytomas in the Pediatric Population
Year: 2018
Type: conference-abstract
Abstract: In this series, we report our experience with 24 pediatric patients (<18yo) with biopsy proven grade I-II astrocytomas who received adjuvant gamma knife (GK) radiosurgery. All patients had previously undergone maximal surgical resection of their brain tumors with subsequent radiographic documentation of residual or recurrent disease. 8.3% of patients had received prior standard chemotherapy with vincrisitine and carboplatin. Patients received a single, outpatient treatment wiht a median 50% isodose of 12 Gy (range 4-18Gy). Median tumor volumes was 1.29cm3 (range 0.04-14.98cm3) No patient experienced post-GK acute toxicity requiring admission or subsequent re-operation. At median follow-up of 3 years (range 1-13yrs), overall survival for the cohort was 100% with 3 and 5 year EFS of 100%. Post-GK new neurologic deficits or subsequent neurologic decline was not identified in any of these patients. Fractionated external beam radiation therapy remains the standard for pediatric brain tumor radiation therapy. Median survival for grade I-II astrocytomas at 5yrs is generally reported around 86-90%. However, EFS post radiation is ≤70% and carries a risk of permanent short and long-term sequelae including neurocognitive deficits, endocrine dysfunction, and development of secondary malignancies. In adults, there are reports of decreased adverse sequelae and increased quality of life measures with GK compared to conventional radiation. The physics of GK stereotactic radiosurgery predict advantages of SRS conformality and specificity relative to conventional external beam radiation. Although longer follow-up is needed, our results extend these conclusions to pediatric brain tumor patients, supporting GK SRS as effective, well tolerated, and safe in the pediatric population.
Source: Neuro-Oncology
Authors: Ashley S Plant, Jody Pathare, Darcy Engelhart, Venita Williams, Ivan Kirov, William G Loudon
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2809581998