Brainstem astrocytomas: The radiosurgical approach

V. Valentino, M. Benassi, L. Strigari

Research output: Contribution to journalArticlepeer-review

Abstract

Between 1987 and 1998, radiosurgery was performed on 20 cases of brainstem gliomas in patients of ages varying from eight months to 56 years, 11 of whom had low grade tumours and nine malignant growths. Six of the cases were children (ranging from eight months to 16 years). Six of the patients had undergone histological examinations. In fourteen cases, diagnosis of infiltrating brainstem tumour, and the distinction between high and low grade gliomas, was determined clinically and in particular through neuroradiology. In the histologically determined cases there was a pylocytic astrocytoma, a fibrillary astrocytoma, an astrocytoma II, two anaplastic astrocytomas and an angioglioma. The mean 25 mm target dose was 15 Gy in low grade tumours and 36 Gy in malignant gliomas. Of the 11 low grade tumour cases, nine patients are in an excellent state of health after follow-ups of between eight and 17 years. The average survival rate for high grade tumour cases was slightly more than 12 months (with a range of four to 25 months). In two cases of low grade glial tumour, the patients had previously undergone unsuccessful fractionated irradiation. The results presented lead to the conclusion that: 1) in cases of diffuse glioma, radiosurgery vs neurosurgery or even fractionated irradiation does not even appear to be an option, but merely a simple decision to use a new form of treatment; 2) neurosurgery may perhaps be an alternative in selected focal or exophytic tumours; 3) neuroradiology techniques, which are also classic methods for distinguishing the specific nature of glial tumours, 'naturally' relegate routine brainstem tumour biopsy to the pages of neurosurgical history.

Original languageEnglish
Pages (from-to)539-547
Number of pages9
JournalRivista di Neuroradiologia
Volume17
Issue number4
Publication statusPublished - Aug 2004

Keywords

  • Astrocytomas
  • Brainstem
  • Radiosurgery

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Radiological and Ultrasound Technology

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