Pineal region gliomas : a single center experience with 25 cases

Abstract Introduction Pineal region glioma is a rare systematically reported tumor in literatures ,little is known about its behavior ,development and best treatment strategies due to its complex anatomical relationship and rarity. Objective We review the outcomes of patients with pineal region gliomas in West China hospital in past five years and retrieve the literatures to add more information. As a result , key factors related to prognosis are identified. Methods 25 patients with pineal region gliomas are selected, information are collected about detailed medical history ,imaging data ,treatment methods , pathological results and latest neurosurgical, radiological progress during follow up. Results Pilocytic astrocytomas (20%) and glioblastoma (24%) were the most common pathological subtypes. 23 patients went through open surgery, 3 GKRS and 4 WBRT . CHT was applied to 3 patients . Low grade gliomas tended to have a better prognosis than high grade. Karnofsky Performance Status score at admission(≤60) was intimately associated with prognosis for low grade gliomas. As for high grade gliomas , age at admission(≤30) had better prognosis than older(＞30). However ,whatever the grade was, there was no overall survival difference as to gender , GTR vs nGTR , preoperative maximal tumor diameter (≤4 cm VS ＞4cm), and time since first symptoms（≤30 days VS＞30 days）, and RT VS not. Conclusion Open surgery is the first line strategy for pineal region gliomas with tolerable mortality and disability rate . Radiosurgery and CHT can be applied as adjuvant or alternative methods when surgery is contraindicated.