Introduction: Central neurocytoma (CN) typically presents as an intraventricular mass causing symptomatic obstructive hydrocephalus. As such, the first line of treatment is surgical resection. Gross total resection is achieved in 60-100% of microsurgeries; recurrence occurs in 20% of patients. Because of a relatively high recurrence rate, conventional radiotherapy (cRT) was initially used as an adjuvant therapy. Stereotactic radiosurgery (SRS) was proposed as an alternative adjuvant or even primary treatment because of its lower risks.
Methods: A systematic analysis for CN treated with SRS conducted in PubMed. Reported patient raw data was aggregated and analyzed for tumor local control rate and 95% CI. Heterogeneity and publication bias were also assessed.
Results: The estimated cumulative rate of tumor control was 91.2% (95% CI=84.3%-95.2%). Mean follow-up time was 64.9 months (range 3-141 months). P-value under random-effect model was < 0.0001. Heterogeneity and publication bias were not significant among eligible studies.
Conclusions: Our data suggests that SRS may be an effective and safe alternative therapy for CN. However, the rarity of CN still limits the efficacy of a quantitative analysis. A future multi-institutional randomized trial of CN patients should be considered to further elucidate this therapy.
Patient Care: Our research suggests that stereotactic radiosurgery is an effective adjuvant treatment modality for recurrent and/or residual central neurocytoma. This allows for SRS to be used as an alternative to cRT with less adverse effects such as leukoencephalopathy, cognitive dysfunction, and secondary malignancies.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of determining adjuvant therapy efficacy for central neurocytoma, 2) Discuss, in small groups, the benefits of stereotactic radiosurgery over conventional radiotherapy for treatment of central neurocytoma, 3) Identify an effective treatment for recurrent or residual central neurocytoma.