Artikel Jurnal

Radiotherapy Protocol of Central Neurocytoma for Resource-limited Settings in the Absence of Official Guidelines: A Case Report and Review of the Literature

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BACKGROUND: Central neurocytoma (CN) is one of the rarest brain tumors which can cause considerable threats to the patient. Studies and trials regarding its treatment are scarce, and no official guidelines are dedicated to this disease. The main principle of treatment generally consists of surgery and radiotherapy. The choice of radiotherapy is divided into conventional fractionated radiotherapy and stereotactic radiosurgery (SRS). However, access to SRS in developing countries such as Indonesia is still limited.AIM: We report a case delineating the timeline and process of treatment in CN with a review of the literature. METHODS:We report the case of a 29-year-old woman with a solid inhomogeneous mass (AP 5.63 × CC 5.36 × LL 5.16cm)in the right ventricle, attached to the septum pellucidum, as displayed on the magnetic resonance imaging (MRI). The patient had been vomiting for the past threeweeks and presented with bidirectional horizontal nystagmus. RESULTS:Cognitive evaluation with Montreal Cognitive Assessment (MoCA-Ina) demonstrated a mild cognitive impairment. Biopsy was performed, and pathology analysis revealed some cells with fibrillary background and some with a honeycomb-like appearance. The immunohistochemistry staining showed positive results with synaptophysin and neuronal nuclear protein. According to the WHO classification of the central nervous system tumors, the profile favored CN GradeII. Subtotal resection (STR) was performed to reduce the tumor mass, which was measured with MRI 2-month post-surgery (AP 4.09 × CC 3.01 × LL 4.13cm) and then followed by an external radiation program. Using intensity modulated radiation therapy (IMRT), a total dose of 54Gy was given in 27 fractions, with the average planning target volume of 54.3Gy. There was a minuscule reduction in tumor mass as seen in post-radiotherapy MRI (AP 4.00 × CC 3.86 × LL 3.63cm). After the last session and at the 18-month follow-up, the patient did not have any complaints or abnormalities during clinical assessment. Reevaluation using MoCA-Ina showed an improved cognitive function.CONCLUSIONS: In line with recent evidence, we demonstrated that STR followed by IMRT with the dosage of 54Gy in 27 fractions was a feasible treatment strategy for CN that resulted in cognitive improvement, with no side effects

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Availability

Detail Information

Series Title

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Call Number

362.1 DIO r

Publisher

Makedonia : Open Access Macedonian Journal of Medical Sciences., 2022

Collation

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Language

English

ISBN/ISSN

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Classification

362.1

Content Type

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Media Type

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Carrier Type

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Edition

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Subject(s)

Neurocytoma
Brain Neoplasms
Clinical Protocols

Specific Detail Info

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Statement of Responsibility

Dion Firli Bramantyo

Viewer

36

Other Information

Tanggal Pelaksanaan - Dari

2024-12-31

Tanggal Pelaksanaan - Sampai

2024-12-31

Akreditasi

Tidak

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