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J Korean Soc Ther Radiol Oncol > Volume 20(2); 2002 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2002;20(2): 100-107.
A Role of Trial Radiation Therapy in the Pineal Region Tumors
Yeon Shil Kim, Mi Ryung Ryu, Su Mi Chung, Moon Chan Kim, Sei Chul Yoon
1Department of Radiation Oncology, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. scyoon@comc.cuk.ac.kr
2Department of Neurosurgery, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
3Department of Catholic Cancer Center, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
The aim of this retrospective study was to assess the treatment results of 30 patients with pineal region tumors who were underwent radiation therapy under the diagnosis by either CT or MRI. There was no histological verification. We analyzed the prognostic factors that have a significant effect on the overall survival (OS) and disease free survival (DFS) rates.
A total 30 patients with pineal region tumors were treated between March 1983 and August 1995. After a trial radiation therapy of 20~30 Gy/2~3 weeks, the patients were evaluated for their clinical response and radiological response by either CT or MRI and the final treatment direction was then decided. According to their response to the trial radiation therapy and the involved site, radiation treatment was given in various fields i.e., local, ventricle, whole brain and craniospinal field. The radiation dose ranged from 40.8 to 59.4 Gy (Median 50.4 Gy). The median follow up was 36.5 months (4~172 months).
An improvement or stability in the clinical symptoms was observed in 28 patients (93.3%) after the trial RT. Nineteen patients (63.3%) showed a partial or complete response by CT or MRI. The two-year and five-year survival rates of the patients were 66.7% and 55.1%, respectively. No significant difference in the survival rates according to the degree of the radiological response was abserved after the trial RT. The results of univariate analysis showed that age, the primary site, the performance status (KPS>or=70), the degree of response after completing RT and the RT field were significant prognostic factors affecting the survival and disease free survival rates (p<0.05).
The clinical and histological characteristics of pineal region tumors are quite complex and diverse. Therefore, it is difficult to predict the histological diagnosis and the possibility of radiocurability only with the initial response to RT. We think that the development of less invasive histological diagnostic techniques and tailored treatment to the histological type of each tumor are needed.
Key Words: Central brain tumors, Pineal region tumors, Trial radiation therapy
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