Gamma Knife Surgery for the Pineal Region Tumors

Abstract

Objective : Gamma Knife Surgery(GKS) for the management of pineal region tumors is challengeable strategy as direct access to this area is not easy. The experiences of pineal region tumor patients treated with GKS were analyzed to evaluate the effectiveness.

Methods : Seven patients with tumors in the pineal region were treated with GKS between September 1998 and May 2005. The histological diagnosis were pineal parenchymal tumor (2 patients), low-grade astrocytoma (2 patients), immature teratoma (1 patient), and choriocarninoma (1 patient). One patient was diagnosed as metastatic brain tumor based on histological diagnosis for primary site and brain imaging study. The median marginal dose was 15Gy (range; 11~20) at the 50% isodose line. The median target volume was 2.5cm3 (range; 0.8~12.5). The median clinical follow up period was 29 months (range; 13~93) and the median radiological follow up period was 18 months (range; 6~73).

Results : Tumor volume measured in follow-up images showed reduction in six patients, disappearance in one. No adverse effect due to GKS was found during the follow-up period . The performance status was preserved in all patients except one who died due to progression of primary cancer in spite of controlled metastatic brain lesion.

Conclusion : Gamma Knife Surgery can be applied to pineal region tumors irrespective of their histology whenever surgery is not indicated.