Long-term outcomes of adjuvant radiotherapy after surgical resection of central neurocytoma
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RESEARCH
Open Access
Long-term outcomes of adjuvant radiotherapy after surgical resection of central neurocytoma Yi-Dong Chen1, Wen-Bin Li1*, Jin Feng3 and Xiao-Guang Qiu2*
Abstract Background and purpose: The role of adjuvant radiotherapy for central neurocytomas (CNs) is not clear. Therefore, we aimed to examine the clinical outcomes of treating histologically confirmed CNs with adjuvant RT after surgical resection. Material and methods: Sixty-three CN patients were retrospectively evaluated: 24 patients underwent gross total resection (GTR); 28, subtotal resection (STR); 9, partial resection (PR), and 2, biopsy (Bx). They underwent adjuvant RT after surgery (median dose, 54 Gy). Results: The median follow-up was 69 months (15–129 months). The 5-year overall survival (OS) and 5-year progression-free survival (PFS) were 94.4% and 95% after GTR + RT, 96.4% and 100% after STR + RT, and 100% and 90.9% after PR + RT. Only three patients had tumor recurrence: at the primary site at 30 and 24 months in two GTR + PR patients, and dissemination to the spinal cord at 75 months in one STR + RT patient. Thirty-eight (63.3%) patients experienced late neurotoxicity (28, grade 1; 7, grade 2; 3, grade 3). Short-term memory impairment was the most common toxicity. Conclusions: RT after incomplete resection (IR) led to OS and PFS comparable to those for GTR. Considering the excellent outcomes and limited late toxicity, adjuvant RT maybe a good option for CN patients who undergo IR. Keywords: Central neurocytoma, Radiotherapy, Toxicity, Resection, Adjuvant therapy
Introduction Central neurocytomas (CNs) of World Health Organization (WHO) grade II [1] are uncommon tumors of the central nervous system and represent approximately 0.25–0.5% of all intracranial tumors. CN was described for the first time in 1982 by Hassoun and co-workers, and, by the early 1990s, it had become a well-defined clinical and pathological entity [2]. CNs are typically located supratentorially in the lateral ventricle(s) and/or the third ventricle. CN used to be considered a benign tumor due to the excellent clinical outcomes after treatment. However, long-term follow-up showed that CNs had a higher recurrence rate than expected, even after complete resection [3]. Because of the rarity of this tumor, no randomized clinical trials on CNs have been performed. Treatment * Correspondence: [email protected]; [email protected] 1 Capital Medical University Cancer Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China 2 Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China Full list of author information is available at the end of the article
strategies have been based on case reports and retrospective studies on small populations [4-6]. Surgery is the mainstay of treatment, and the extent of surgery is the most important prognostic factor affecting clinical outcomes [7]. In addition, radiotherapy (RT) can successfully control residual tumor after incomplete resection or recurrence [3,8]. It is
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