OBJECTIVE: Central neurocytomas (CNs) are uncommon intraventricular tumors, and their rarity renders the risk-to-benefit profile of stereotactic radiosurgery (SRS) unknown. The aim of this multicenter, retrospective cohort study was to evaluate the outcomes of SRS for CNs and identify predictive factors. METHODS: The authors retrospectively analyzed a cohort of patients with CNs treated with SRS at 10 centers between 1994 and 2018. Tumor recurrences were classified as local or distant. Adverse radiation effects (AREs) and the need for a CSF shunt were also evaluated. RESULTS: The study cohort comprised 60 patients (median age 30 years), 92% of whom had undergone prior resection or biopsy and 8% received their diagnosis based on imaging alone. The median tumor volume and margin dose were 5.9 cm3 and 13 Gy, respectively. After a median clinical follow-up of 61 months, post-SRS tumor recurrence occurred in 8 patients (13%). The 5- and 10-year local tumor control rates were 93% and 87%, respectively. The 5- and 10-year progression-free survival rates were 89% and 80%, respectively. AREs were observed in 4 patients (7%), but only 1 was symptomatic (2%). Two patients underwent post-SRS tumor resection (3%). Prior radiotherapy was a predictor of distant tumor recurrence (p = 0.044). Larger tumor volume was associated with pre-SRS shunt surgery (p = 0.022). CONCLUSIONS: Treatment of appropriately selected CNs with SRS achieves good tumor control rates with a reasonable complication profile. Distant tumor recurrence and dissemination were observed in a small proportion of patients, which underscores the importance of close post-SRS surveillance of CN patients. Patients with larger CNs are more likely to require shunt surgery before SRS.

Department of Neurological Surgery University of Virginia Health System Charlottesville Virginia

Department of Neurosurgery Cleveland Clinic Foundation Cleveland Ohio

Department of Neurosurgery Department of Surgery Chi Mei Medical Center Tainan Taiwan

Department of Neurosurgery Neurological Institute Taipei Veterans General Hospital Taipei Taiwan

Department of Neurosurgery NYU Langone Health System New York New York; and

Department of Neurosurgery University of Pittsburgh Pittsburgh Pennsylvania

Department of Radiation Oncology University of Colorado Cancer Center Aurora Colorado

Department of Radiation Oncology William Beaumont Hospital Royal Oak Michigan

Department of Recreation and Healthcare Management Chia Nan University of Pharmacy and Science Tainan Taiwan

Departments of Stereotactic and Radiation Neurosurgery and

Departments of10Neurosurgery and

Gamma Knife Center Beijing Neurosurgical Institute Beijing Tiantan Hospital Capital University of Medical Sciences Beijing China

Neurosurgery Na Homolce Hospital Prague Czech Republic

Radiation Oncology University of Louisville Kentucky

School of Medicine National Yang Ming University Taipei Taiwan

Université de Sherbrooke Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke Québec Canada

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The role of single fraction Gamma Knife radiosurgery for intraventricular central neurocytomas and the utility of F-18 fluroethyltyrosine: two case reports