Long-Term Outcomes of Stereotactic Radiosurgery for Papillary Tumors of the Pineal Region: A Multicenter Retrospective Study
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: Papillary tumors of the pineal region (PTPR) are rare neuroepithelial tumors that are at high risk of local recurrence even after gross total resection. Their optimal management, including the potential role of stereotactic radiosurgery (SRS), remains a matter of debate. Only a few retrospective outcome studies have been reported. This study was designed to provide multi-institutional data to strengthen the evidence related to the use of SRS for PTPR. METHODS: Centers participating in the International Radiosurgery Research Foundation were asked to provide data for patients who had SRS and at least 6 months of follow-up for a histology-confirmed PTPR. RESULTS: In total, 19 patients (12 male and 7 female) underwent SRS for PTPR in 6 institutions: 7 patients had primary SRS after biopsy, 9 had adjuvant SRS, and 3 had SRS for recurrent tumor. The median margin dose used was 16 Gy, and median treatment volume was 1.73 cc. Initial local control was achieved in all patients after SRS, with a median progression-free survival of 5 years. A total of 6 patients had local recurrence, managed by repeat SRS in 4 patients, surgical resection in 1, and both interventions in the other. The cumulative actuarial local control at 20 years, considering additional SRS procedures as needed, was 69%. One patient had ventricular and leptomeningeal dissemination which led to death. The mean survival duration was 15.8 years, with an estimated survival rate of 83% at 10 years and 69% after 20 years. Adverse radiation effects were observed in 5 cases, 4 of which were symptomatic, but eventually resolved in all patients. CONCLUSION: SRS for PTPR is safe and enables local tumor control in most cases. SRS can be considered as primary management after diagnosis of PTPR.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".