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Central Neurocytoma Treatment Modalities: A Systematic Review Assessing the Outcomes of Combined Maximal Safe Resection and Radiotherapy with Gross Total Resection
Central Neurocytoma Treatment Modalities: A Systematic Review Assessing the Outcomes of Combined Maximal Safe Resection and Radiotherapy with Gross Total Resection
- Source :
- World Neurosurgery. 137:e176-e182
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background Central neurocytomas (CNCs) are rare intraventricular lesions comprising Objective Our goal was to update Rades et al.‘s 2006 systematic review to assess the outcome differences among 3 fundamental therapies for CNC: gross total resection with and without radiation therapy (RT) versus maximal safe resection with adjuvant RT. Methods Articles indexed on PubMed and Google Scholar and published between January 1, 2006 and December 31, 2019 were selected using the PRISMA criteria. Studies were excluded if they had fewer than 3 cases, did not categorize extent of resection, or were duplicate studies, technical reports, case reports, or studies without follow-up. Complication rates, recurrence rates, overall survival and progression-free survival were extracted where possible. χ2 proportionality tests were used for comparison (P values >0.05 suggested significance). Results On aggregation, 615 patients from 13 studies including ours were assessed. Although overall survival was not significantly different (χ2 = 1.56; P = 0.46), the recurrence rate differed significantly between GTR + RT (6.9%, 92.11 months), GTR–RT (23.9%, 96.8 months), and MSR + RT (16.8%, 85 months) (χ2 = 10.94; P = 0.004). Pooled complication rates for GTR and MSR + RT were 31.2% and 24% (P = 0.049), respectively. Conclusions RT remains an important adjuvant treatment that can improve patient survival in the presence of MSR to levels comparable to those of GTR or GTR + RT. Where total resection carries too much risk, MSR + RT can be considered as the next best alternative for tumor control.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Extent of resection
Neurosurgical Procedures
Resection
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
medicine
Central neurocytoma
Humans
Neurocytoma
Brain Neoplasms
business.industry
medicine.disease
Combined Modality Therapy
Gross Total Resection
Surgery
Radiation therapy
Treatment Outcome
Treatment modality
030220 oncology & carcinogenesis
Radiotherapy, Adjuvant
Neurology (clinical)
Neoplasm Recurrence, Local
Complication
business
Adjuvant
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 18788750
- Volume :
- 137
- Database :
- OpenAIRE
- Journal :
- World Neurosurgery
- Accession number :
- edsair.doi.dedup.....8eba697670661990fedc9de94abc5eee
- Full Text :
- https://doi.org/10.1016/j.wneu.2020.01.114