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

Table 1 Selected series of stereotactic irradiation for management of pilocytic astrocytoma in pediatric and adult patients

Ref.	Publication year and study period	Histology	Number of patients	Age (yr)	Setting	Treatment	Tumor size	Dose	Prior RT	Follow-up duration	PFS / tumor control
Murphy et al[42]	2019 (1990-2016)	PA	141	Median age 14 yr (range: 2-84 yr)	As part of initial management or salvage therapy	GKSRS	Median 3.45 cc	Median margin dose 16 Gy	21 patients	Median 67.3 mo	PFS 74.0% at 5 yr; PFS 69.7% at 10 yr
Trifiletti et al[43]	2017 (1990-2015)	PA	28	Median age 17.4 yr (range: 2-70.3 yr)	As part of initial management or salvage therapy	GK-based SRS or SRT	Median 1.84 cc	Median margin dose 16 Gy for single fraction SRS, and 15 Gy delivered in 3 fractions for SRT	4 patients	Median 5.4 yr	PFS 96% at 6 yr; Tumor control 93%
Simonova et al[44]	2016 (1992-2002)	PA	25	Median age 13 yr (range: 3-17 yr)	As part of initial management or salvage therapy	GK-based SRS or SRT	Median 2.7 cc	Median margin dose 16 Gy for patients receiving single fraction, median dose 25 Gy delivered in 5 fractions for SRT	2 patients	Median 15 yr	PFS 80% at 10 yr
Lizarraga et al[45]	2012 (1995-2010)	PA	12	Median age 21 yr (range: 5-41 yr)	Salvage therapy	LINAC-based SRS or SRT	Median 6.5 cc for SRT; Median 1.69 cc for SRS	Median dose 18.75 Gy for SRS and median dose 50.4 Gy delivered in 28 fractions for SRT	0 patients	Median 37.5 mo	PFS 73.3% at long term
Hallemeier et al[46]	2012 (1992-2005)	PA	18	Median age 23 yr (range: 4-56 yr)	As part of initial management or salvage therapy	GKSRS	Median 9.1 cc	Median margin dose 15 Gy	10 patients	Median 8 yr	PFS 41% at 5 yr; Tumor control 75%
Kano et al[47]	2009 (1987-2006)	PA	50	Median age 10.5 yr (range: 4.2-17.9 yr)	As part of initial management or salvage therapy	GKSRS	Median 2.1 cc	Median margin dose 14.5 Gy	5 patients	Median 55.5 mo	PFS 70.8% at 5 yr
Kano et al[48]	2009 (1994-2006)	PA	14	Median age 32 yr (range: 19-52 yr)	As part of initial management or salvage therapy	GKSRS	Median 4.7 cc	Median margin dose 13.3 Gy	6 patients	Median 36.3 mo	PFS 31.5% at 5 yr
Hadjipanayis et al[49]	2002(1987-2000)	PA	37	Median age 14 yr (range: 3-52 yr)	As part of initial management or salvage therapy	GKSRS	Median 3 cc	Median margin dose 15 Gy	9 patients	Median 28 mo after GKSRS	Tumor control 68%
Boëthius et al[50]	2002 (1978-1997)	PA	19	Mean age 10.6 yr (range: 2-60 yr)	Adjuvant therapy	GKSRS	Median 2.2 cc	Median margin dose 10 Gy	2 patients	Median radiological follow-up 4.7 yr	Tumor control 94.7%
Somaza et al[51]	1996 (1990-1993)	PA	9	Mean age 8.6 yr (range: 4-17 yr)	Adjuvant or salvage therapy	GKSRS	Mean tumor diameter 16 mm	Median margin dose 15 Gy	2 patients	Median 19 mo	Tumor control 100%

GKSRS: Gamma Knife stereotactic radiosurgery; LINAC: Linear accelerator; PA: Pilocytic astrocytoma; PFS: Progression-free survival; SRS: Stereotactic radiosurgery; SRT: Stereotactic radiation therapy.