Systematic Analysis of the Outcomes of Stereotactic Radiosurgery for Central Neurocytoma

Introduction: Central neurocytomas typically affect young adults, arise in the lateral ventricles, and represent 0.1–0.5% of all intracranial tumors. The current treatment of choice is gross total resection (GTR). For recurrent or residual tumors, reoperation or conventional radiotherapy has typically been used. Because central neurocytomas are surrounded by CSF and have little connection to the surrounding brain parenchyma, they serve as ideal targets for SRS. Hence, SRS may reduce the need for reoperation and minimize exposure to radiation compared with conventional radiotherapy (cRT). Here, we analyze the benefits of SRS after no resection, gross total resection (GTR), and subtotal resection (STR) to determine whether SRS is a viable alternative to current treatments.

Methods: A PubMed search was performed with the keywords “neurocytoma” and “neurocytoma and radiosurgery” to identify all relevant cases. Reports were excluded if patients had both cRT and SRS or if tumor size was absent.

Results: A total of 66 patients with neurocytoma undergoing SRS met our inclusion criteria. The average tumor reduction was 64% at an average peripheral dose of 14 Gy, and average time of radiological follow-up was 50.3 months. One patient experienced radiation-related toxicity, 6 had recurrence after SRS, 11 underwent SRS as a primary treatment, and none experienced toxicity or recurrence.

Conclusion: SRS for the treatment of neurocytoma has been demonstrated to be effective in case reports and case series. Similarly, the results of this study clearly show a decrease in tumor size, good control over time and few adverse radiation-related outcomes. Furthermore, our results suggest that SRS could serve as an alternative to reoperation and cRT and as a primary treatment. Additional studies and patient data will be needed to elucidate the role of SRS in the management of neurocytoma.