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Concise review of radiosurgery for contemporary management of pilocytic astrocytomas in children and adults

World Journal of Experimental Medicine 2022年第3期12卷 36-43页

作者： Omer Sager Ferrat Dincoglan Selcuk Demiral Bora Uysal Hakan Gamsiz Esra Gumustepe Fatih Ozcan Onurhan Colak Ahmet Tarik Gursoy cemal ugur dursun Ahmet Oguz Tugcu Galip Dogukan Dogru Rukiyye Arslan Yelda Elcim Esin Gundem Bahar Dirican Murat Beyzadeoglu Department of Radiation Oncology Gulhane Medical FacultyUniversity of Health SciencesAnkara 0090Turkey

Pilocytic astrocytoma(PA)may be seen in both adults and children as a distinct histologic and biologic subset of low-grade glioma.Surgery is the principal treatment for the management of PAs;however,selected patients may benefit from irradiation particularly in the setting of inoperability,incomplete resection,or recurrent disease.While conventionally fractionated radiation therapy has been traditionally utilized for radiotherapeutic management,stereotactic irradiation strategies have been introduced more recently to improve the toxicity profile of radiation delivery without compromising tumor control.PAs may be suitable for radiosurgical management due to their typical appearance as well circumscribed lesions.Focused and precise targeting of these well-defined lesions under stereotactic immobilization and image guidance may offer great potential for achieving an improved therapeutic ratio by virtue of radiosurgical techniques.Given the high conformality along with steep dose gradients around the target volume allowing for reduced normal tissue exposure,radiosurgery may be considered a viable modality of radiotherapeutic management.Another advantage of radiosurgery may be the completion of therapy in a usually shorter overall treatment time,which may be particularly well suited for children with requirement of anesthesia during irradiation.Several studies have addressed the utility of radiosurgery particularly as an adjuvant or salvage treatment modality for PA.Nevertheless,despite the growing body of evidence supporting the use of radiosurgery,there is need for a high level of evidence to dictate treatment decisions and establish its optimal role in the management of PA.Herein,we provide a concise review of radiosurgery for PA in light of the literature.

关键词： Pilocytic astrocytoma Radiosurgery Stereotactic irradiation Low-grade glioma Radiation oncology Children

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