P14LOCALISED RADIATION THERAPY FOR PINEAL PARENCHYMA TUMOUR WITH INTERMEDIATE DIFFERENTIATION: A SINGLE INSTITUTE EXPERIENCE

INTRODUCTION: Pineal Parenchyma tumour with intermediate differentiation (PPTID) is a rare disorder, first classified by World Health Organisation in 2000.There are very few published data available and optimal management is yet to be determined. Management has varied from surgery alone to craniospinal radiotherapy with or without chemotherapy. We present our experience of PPTID treated with radiotherapy alone. METHOD: We conducted a retrospective review of patients who were diagnosed with PPTID and treated with radiation therapy at our institute from 2011 onwards. RESULTS: Between January 2011 to January 2014, 4 patients of PPTID were treated at our institute. Median age is 44 (range 24 to 61). All patients had preoperative MRI scan of brain and spine. Imaging did not identify any cerebrospinal fluid (CSF) dissemination. None of the patients underwent a gross total resection, due to the tumour location and technical difficulties. All patients were treated with external beam radiation therapy to primary lesion with a dose of 54 Gee in 30 fractions after surgery. 2 patients had good partial response (near complete response) and the remaining 2 have recently completed their treatment. Patients with partial response remain relapse free after 15 and 9 months. So far there is no evidence of cerebral white matter abnormalities on MRI scan or neurocognitive disorders. CONCLUSION: Localised radiotherapy for PPTID patients without CSF dissemination may be a valid treatment option, although more mature data is required to assess overall and disease free survival and adverse effect.