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Radiotherapy for subependymal giant cell astrocytoma: time to challenge a historical ban? A case report and review of the literature.
- Source :
-
Journal of medical case reports [J Med Case Rep] 2024 Jul 20; Vol. 18 (1), pp. 330. Date of Electronic Publication: 2024 Jul 20. - Publication Year :
- 2024
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Abstract
- Background: Subependymal giant cell astrocytoma is a benign brain tumor that occurs in patients with tuberous sclerosis complex. Surgical removal is the traditional treatment, and expert opinion is strongly against the use of radiotherapy. Recently, success has been reported with the mTor inhibitor everolimus in reducing tumor volume, but regrowth has been observed after dose reduction or cessation.<br />Case Report: We present the case of a 40-year-old Asian female patient treated successfully for growing bilateral subependymal giant cell astrocytoma with fractionated stereotactic radiotherapy before everolimus became available. After a follow-up of 8 years, everolimus was administered for renal angiomyolipoma and the patient was followed up until 13 years after radiotherapy. Successive magnetic resonance imaging demonstrated an 80% volume reduction after radiotherapy that increased to 90% with everolimus. A review of the literature was done leveraging Medline via PubMed, and we assembled a database of 1298 article references and 780 full-text articles in search of evidence for contraindicating radiotherapy in subependymal giant cell astrocytoma. Varying results of single-fraction radiosurgery were described in a total of 13 cases. Only in two published cases was the radiation dose of fractionated radiotherapy mentioned. One single publication mentions an induced secondary brain tumor 8 years after whole-brain radiotherapy.<br />Conclusion: There is no evidence of contraindication and exclusion of fractionated radiotherapy in treating subependymal giant cell astrocytoma. Our experience demonstrates that subependymal giant cell astrocytoma, as other benign intracranial tumors, responds slowly but progressively to radiotherapy and suggests that fractionated stereotactic radiotherapy holds promise to consolidate responses obtained with mTor inhibitors avoiding regrowth after cessation.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Female
Adult
Magnetic Resonance Imaging
Antineoplastic Agents therapeutic use
Treatment Outcome
Kidney Neoplasms radiotherapy
Kidney Neoplasms pathology
Tuberous Sclerosis complications
Astrocytoma radiotherapy
Astrocytoma surgery
Brain Neoplasms radiotherapy
Radiosurgery
Everolimus therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1752-1947
- Volume :
- 18
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of medical case reports
- Publication Type :
- Academic Journal
- Accession number :
- 39030575
- Full Text :
- https://doi.org/10.1186/s13256-024-04649-2