Non-resective management of pineoblastoma

The results of a non-resective treatment approach for pineoblastoma compris ing stereotactic biopsy, cerebrospinal fluid diversion, and fractionated ra diotherapy in six patients over a period of six years are presented. There were three male and three female patients, with a median age at diagnosis o f 20 years. Magnetic resonance imaging of the spine, ventricular cerebrospi nal fluid cytology, and tumour markers in cerebrospinal fluid were negative . Tumour response to initial radiotherapy was complete in three patients an d partial in three patients. Recurrences were treated with interstitial irr adiation with iodine-125 seeds in four instances, repeat radiotherapy when time elapsed was more than five years in one instance, with surgical resect ion in two instances, and chemotherapy in two instances. The diagnostic and therapeutic effectiveness of this management strategy is assessed. There w ere no complications related to surgical procedures. The median follow-up t ime was 48 months (range 14-70 months). Five patients were alive at 14, 45, 51, 57, and 70 months of follow-up. One patient died of disease at 28 mont hs following diagnosis. The overall survival rate was 80% +/- 17.89% at 28 months. The results of this study suggest that this non-resective treatment approach is acceptable as an initial treatment alternative to radical surg ical resection of pineoblastomas.