Stereotactic radiation in primary brain tumors in children and adolescents

To evaluate treatment outcome and morbidity of stereotactic external-beam i rradiation (SEBI) in pediatric patients, we reviewed 14 children treated wi th SEBI, using a 10-MV isocentric linear accelerator at McGill University b etween 1988 and 1994. The median follow-up was 46 months (range 6-82 months ). The median age was 14 years. There were 8 low-grade astrocytomas, 3 neur omas and 4 other histologies. Twelve patients received fractionated treatme nts. The median collimator diameter was 2.5 cm (range 1-5 cm). The median b iological effective dose delivered to the entire tumor volume was 57 Gy for astrocytomas and 43 Gy for the other histologies. The overall actuarial su rvival rate and disease-free survival rate at 5 years were 83 and 62%, resp ectively. For the patients with low-grade astrocytomas, the 5-year survival and disease-free survival rates were 100 and 60%, respectively. Four child ren had recurrence at a median of 37 months. Four patients developed treatm ent-related complications: 1 had edema alone, 2 had necrosis and 1 had edem a associated with necrosis. Neither the physical nor radiobiological parame ters were predictive of the treatment outcome or the treatment complication s. Stereotactic irradiation is a valid option for progressive nonresectable tumors in children. Copyright (C) 1999 S. Karger AG, Basel.