Mantziaris Georgios, Diamond Joshua, Pikis Stylianos, El Hefnawi Farid M, Al Sideiri Ghusn, Coupé François-Louis, Mathieu David, Lee Cheng-Chia, May Jaromir, Liščák Roman, Peker Selcuk, Samanci Yavuz, Niranjan Ajay, Lunsford L Dade, Sheehan Jason P
1Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia.
2Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio.
J Neurosurg. 2022 Mar 25;137(5):1248-1253. doi: 10.3171/2022.2.JNS212813. Print 2022 Nov 1.
The optimal treatment for recurrent and residual gangliogliomas remains unclear. The aim of this study was to evaluate the safety and efficacy of stereotactic radiosurgery (SRS) in the management of patients with recurrent or residual intracranial ganglioglioma.
This retrospective multicenter study involved patients managed with SRS for ganglioglioma. The study endpoints included local tumor control and tumor- or SRS-related neurological morbidity following treatment. Factors associated with tumor progression and neurological morbidity were also analyzed.
The cohort included 20 patients (11 males [55%]) with a median age of 24.5 (IQR 14) years who had been managed with SRS for ganglioglioma. Five-year radiological progression-free survival was 85.6%. After SRS, 2 patients (10%) experienced transient neurological deterioration. At a median clinical follow-up of 88.5 (IQR 112.5) months, 1 patient (5%) experienced seizure worsening and 1 (5%) required further resection of the tumor because of radiological progression. No mortality was noted in this series.
SRS appears to be a safe and effective treatment option for surgically inaccessible, recurrent, and residual gangliogliomas. In this series, the 5-year progression-free survival rate after SRS was 85.6%. Gross-total resection remains the primary treatment of choice for patients with newly diagnosed or recurrent ganglioglioma. SRS may be considered for patients unfit for surgery and those with surgically inaccessible newly diagnosed, residual, and recurrent lesions.
复发性和残留性神经节胶质瘤的最佳治疗方法仍不明确。本研究的目的是评估立体定向放射外科（SRS）治疗复发性或残留性颅内神经节胶质瘤患者的安全性和有效性。
这项回顾性多中心研究纳入了接受SRS治疗神经节胶质瘤的患者。研究终点包括治疗后的局部肿瘤控制以及与肿瘤或SRS相关的神经功能障碍。还分析了与肿瘤进展和神经功能障碍相关的因素。
该队列包括20例患者（11例男性[55%]），中位年龄为24.5岁（四分位间距14岁），均接受了SRS治疗神经节胶质瘤。5年无放射学进展生存率为85.6%。SRS治疗后，2例患者（10%）出现短暂性神经功能恶化。在中位临床随访88.5个月（四分位间距112.5个月）时，1例患者（5%）癫痫发作加重，1例（5%）因放射学进展需要进一步切除肿瘤。本系列中未观察到死亡病例。
对于手术难以触及的复发性和残留性神经节胶质瘤，SRS似乎是一种安全有效的治疗选择。在本系列中，SRS治疗后的5年无进展生存率为85.6%。对于新诊断或复发性神经节胶质瘤患者，大体全切仍然是主要的首选治疗方法。对于不适合手术的患者以及新诊断、残留和复发性病变手术难以触及的患者，可以考虑SRS治疗。
