A Review on the Role of Stereotactic Radiosurgery for Pineal Tumors

Abstract

Pineal region tumors, although rare, consist of variable histological entities including germ cell tumors most frequently, followed by pineal parenchymal tumors, gliomas, and other miscellaneous tumors. As different therapeutic strategies are required according to the histological diagnosis, correct tissue diagnosis is essential to provide optimal therapy. Treatment options include surgery, radiation in the form of either fractionated radiotherapy or stereotactic radiosurgery, and chemotherapy. Complete surgical resection can provide a chance of cure for a certain kind of benign tumors such as pineocytomas, although it is not always feasible and the risks of morbidity and mortality should be carefully balanced. For malignant tumors such as germ cell tumors or pineoblastomas, multimodal approaches combining surgery, radiotherapy, and chemotherapy are usually adopted. Stereotactic radiosurgery constitutes one of the viable armamentaria in the treatment of tumors arising in this critical location. It can be used as a primary, adjunct or boost, or salvage treatment, depending on specific tumor types as well as clinical situations.