Long-term clinical effects of radiation therapy for primitive gliomas and medulloblastomas: a role for radiosurgery.

The effect of conventional irradiation on primitive gliomas and medulloblastomas was examined for 21 patients and a role for radiosurgery was evaluated. Five patients survived more than 8 years after treatment. However, side effects were recognized not only on neuronal and hormonal functions but also on neurovascular structures in the developing brain. The remaining patients died due to tumor recurrence, dissemination and/or metastases. Although these tumors were radioresponsive, conventional irradiation was inadequate in more than half the cases. A role for Gamma Knife radiosurgery should be considered, especially for young children and recurrences. Radiosurgery could also conceivably contribute to the prevention of tumor dissemination. In all events a multidisciplinary treatment should be considered.