[Combination treatment for pilocytic astrocytoma: stereotaxic radiosurgery and endocavitary radiotherapy]

Neurochirurgie. 1998 Mar;44(1):50-4.
[Article in French]

Abstract

The treatment of a pilocytic astrocytoma located in a functional area can be performed using radiosurgery. We report a 7 year old male, right-handed, who presented with a pilocytic astrocytoma in the left parieto-occipital lobe. After a 7 year follow-up, the tumor became symptomatic (partial and generalized seizures). The CT scan and nuclear magnetic resonance imaging revealed an increased size of the mural tumor and the development of a cystic component. Multi-beam irradiation of the tumor (dose of 30 Gy at the center with 21 Gy on the isodose 70%) was performed with a LINAC for radiosurgery coupling a modified Saturne 18 MeV linear accelerator and a Talairach stereotactic frame. Following multi-beam irradiation, the increase in size of the cyst imposed further intracavitary radiation using Rhenium 186 (186Re) to deliver 400 Gy to the cyst wall. After a period of intense cerebral edema, resolutive with steroid treatment, we obtained progressive cyst disappearance and mural nodule retraction. A PET scan, performed 3 years after this treatment, revealed no metabolic activity in the persistent mural nodule. The patient remains totally asymptomatic.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Astrocytoma / diagnosis
  • Astrocytoma / pathology
  • Astrocytoma / surgery*
  • Brain / pathology
  • Brain / surgery
  • Brain Diseases / surgery
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / pathology
  • Brain Neoplasms / surgery*
  • Cerebral Cortex / pathology
  • Cerebral Cortex / surgery
  • Child
  • Cysts / surgery
  • Humans
  • Magnetic Resonance Spectroscopy
  • Male
  • Radioisotopes / therapeutic use
  • Radiosurgery*
  • Rhenium / therapeutic use
  • Stereotaxic Techniques
  • Tomography, Emission-Computed

Substances

  • Radioisotopes
  • Rhenium