Distúrbios cerebrais e terapia

Abstrato

Central Neurocytomas: A Comprehensive Review with Special Emphasis on the Role of Gamma Knife Stereotactic Radiosurgery

Nandish Hodaghatta Shivaramegowda, Sachin Anil Borkar, Kanwaljeet Garg, Vaishali Suri, Mehar Chand Sharma, Bhawani Shankar Sharma and Ashok Kumar Mahapatra

Central Neurocytomas (CNs) are uncommon tumors of central nervous system, arising from neuronal cells. Mostly these tumors are intraventricular and commonly occurs at the level of the “Foramen of Monro”. However, recently cases of “Extraventricular Neurocytoma” have also been reported. Typically, CNs are associated with favorable outcome. Best long term prognosis, in terms of local control and survival is achieved by maximal safe surgical resection, which is considered as ideal therapeutic option. However, management of recurrent or residual CNs remains controversial. Treatment options for patients with recurrent or residual CNs includes reoperation, radiotherapy or chemotherapy. Use of conventional radiotherapy in recurrent or residual CNs is associated with long term complications in the form of cognitive abnormalities and risk of developing secondary malignancies. Recently, Gamma Knife Radiosurgery is used in patients with recurrent or residual CNs as an alternative treatment option to conventional radiotherapy. Studies have reported that Gamma Knife Radiosurgery provides safe and effective alternative treatment option for recurrent or residual CNs, by eliminating the long term side effects of conventional radiotherapy. However, these are based on results of limited number of studies, with small sample sizes, with no control groups. Randomized control trials or larger studies are required to confirm the effectiveness of Gamma knife Radiosurgery in recurrent or residual CNs. This paper reviews the findings of case series and case reports that contribute to the effectiveness of Gamma knife Radiosurgery in CNs.