NS-12: GAMMA KNIFE APPLICATION IN PEDIATRIC LOW GRADE ASTROCYTOMAS

INTRODUCTION: Astrocytomas account for twenty-three percent of brain tumors in children. Gamma Knife Radiosurgery (GKRS) is increasingly being utilized in pediatric patients as a means to spare developing children from adverse effects of conventional therapies of chemotherapy, surgery and/or radiation. We reviewed demographics and indications for treatment as well as outcomes in pediatric patients with astrocytomas treated with GKRS. METHODS: 392 charts of patients nineteen years and younger who received GKRS at a single institution from 1993-2014 were reviewed. A minimum of two years post-treatment patient follow up was established by phone call or clinic visit. RESULTS: 59 children with low grade astroctyoma were identified. Nine were selected due to electronic record availability. The mean age at treatment was 11.2 years. Cerebellar involvement was seen in five of nine patients whereas two patients had temporal lobe involvement. Disease recurrence was the indication in five of nine patients. The average treatment dose was 11.5 Gy. A patient with cerebellar vermis involvement deemed unresectable required a second course of GKRS. A second patient with unresectable brainstem tectal astrocytoma developed diplopia secondary to hydrocephalus requiring ventriculoperitoneal shunt revision. Six of nine patients remained stable with improvement in symptomology. CONCLUSION: The use of GKRS in pediatric astrocytomas is a feasible and effective treatment measure. With these results, further studies comparing outcomes of patients receiving conventional therapies with patients who undergo GKRS are warranted.