• Georgios Mantziaris, Joshua Diamond, Stylianos Pikis, Farid M El Hefnawi, Ghusn Al Sideiri, François-Louis Coupé, David Mathieu, Cheng-Chia Lee, Jaromir May, Roman Liščák, Selcuk Peker, Yavuz Samanci, Ajay Niranjan, L Dade Lunsford, and Jason P Sheehan.
• 1Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia.
• J. Neurosurg. 2022 Nov 1; 137 (5): 124812531248-1253.

ObjectiveThe optimal treatment for recurrent and residual gangliogliomas remains unclear. The aim of this study was to evaluate the safety and efficacy of stereotactic radiosurgery (SRS) in the management of patients with recurrent or residual intracranial ganglioglioma.MethodsThis retrospective multicenter study involved patients managed with SRS for ganglioglioma. The study endpoints included local tumor control and tumor- or SRS-related neurological morbidity following treatment. Factors associated with tumor progression and neurological morbidity were also analyzed.ResultsThe cohort included 20 patients (11 males [55%]) with a median age of 24.5 (IQR 14) years who had been managed with SRS for ganglioglioma. Five-year radiological progression-free survival was 85.6%. After SRS, 2 patients (10%) experienced transient neurological deterioration. At a median clinical follow-up of 88.5 (IQR 112.5) months, 1 patient (5%) experienced seizure worsening and 1 (5%) required further resection of the tumor because of radiological progression. No mortality was noted in this series.ConclusionsSRS appears to be a safe and effective treatment option for surgically inaccessible, recurrent, and residual gangliogliomas. In this series, the 5-year progression-free survival rate after SRS was 85.6%. Gross-total resection remains the primary treatment of choice for patients with newly diagnosed or recurrent ganglioglioma. SRS may be considered for patients unfit for surgery and those with surgically inaccessible newly diagnosed, residual, and recurrent lesions.

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