Gamma knife radiosurgery as an efficacious treatment for paediatric central nervous system tumours: a retrospective study of 61 neoplasms.

PURPOSE

Brain tumours have an incidence of 1.15 to 5.14 cases per 100,000 children and are associated with significant morbidity and mortality. Radiosurgery has become a promising approach to manage these paediatric CNS tumours. The aim of the present study was to analyse the efficacy of radiosurgery in the treatment of a variety of paediatric tumours of CNS.

METHODS

This retrospective study was conducted from 1997 to 2012 at a single Neurosurgery centre. All paediatric patients (≤ 18 years of age) with CNS tumours who were treated with gamma knife radiosurgery (GKRS) and had a minimum follow up of 6 months were included in the study. Patients with lesions other than tumours were excluded. Clinical, radiological and GKRS planning data was collected and analysed in all patients.

RESULTS

A total of 76 children with brain tumours had GKRS during the study period. Of these, 40 children (with 61 neoplasms) had follow-up available and were included in the study. The mean age was 16 years (6-18 years). Seventeen patients received primary GKRS, 20 patients received secondary, and 3 patients received both. The median tumour volume was 3.3 cm (0.14-38.9 cm3). The mean dose was 12.56 Gy at 50% isodose line. The majority of the tumours were meningioma (n = 20) followed by acoustic schwannoma (n = 17). The mean treatment time was 67.04 min. Thirty-three tumours responded favourably to GKRS, 24 showed a stable size, 3 had no response while 1 progressed, requiring surgery.

CONCLUSION

GKRS has the potential to become an indispensable tool in the management of paediatric brain neoplasms.