Open AccessNeurocytomas: Long-term experience of a single institution
Author(s) -
Abhirami Hallock,
Burton E. Hamilton,
L. C. Ang,
Keng-Kiong Tay,
J. F. Meygesi,
Barbara Fisher,
Christopher Watling,
David R. Macdonald,
Glenn Bauman
Publication year - 2011
Publication title -
neuro-oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.005
H-Index - 125
eISSN - 1523-5866
pISSN - 1522-8517
DOI - 10.1093/neuonc/nor074
Subject(s) - medicine , central neurocytoma , perioperative , radiation therapy , surgery , retrospective cohort study , radiology , magnetic resonance imaging
There is a lack of studies reporting on outcomes of control and treatment toxicities for neurocytomas. A 25-year retrospective review of a tertiary center's experience with neurocytomas was completed to report on these outcomes. All cerebral neurocytoma cases (19 patients; median age, 31 years; range, 18-62 years; 18 intraventricular and 1 extraventricular) treated between 1984 and 2009 were analyzed, including central pathology and radiology reviews. Median follow-up was 104.5 months (range, 0.75-261.7 months). Primary treatment was surgery alone (n = 18 patients), followed by surgery and adjuvant radiotherapy (n = 1). The crude local control rate after surgery was 68% for all cases (cerebral neurocytomas) and 74% for central neurocytomas. Salvage therapies included further surgery (n = 4), radiation (n = 3), and chemotherapy (n = 1). Ten-year Kaplan-Meier overall and relapse-free survival rates were 82% and 62% and 81% and 57%, respectively, for all cases and for central neurocytomas only. The median overall survival and relapse-free survival were 104.5 and 79.3 months, respectively, for all cases and for central neurocytomas. Ten patients had grade 3/4 toxicity, and 1 patient had a grade 5 perioperative hemorrhage that resulted in death 23 days after surgery. Late grade 3/4 toxicities occurred in 9 patients. Three patients had permanent grade 2 motor or cognitive deficits. We provide the first report outlining toxicities and survival outcomes in a series of 19 patients. Our experience suggests that initial surgery provides durable local control rates in two-thirds of patients, with low risk for significant permanent deficits. Salvage therapy with surgery and/or radiation provides durable local control in tumors that recur after surgery.