Radiation therapy for pineal tumors: 30-year experience at Thomas Jefferson University Hospital

Eighteen tumors of the pineal region were treated at Thomas Jefferson University Hospital since 1957. Preoperative evaluation included CT scan in 11 patients and cerebrospinal fluid cytology in four. Histologic diagnosis was obtained in nine patients. Diagnosis in two other patients was based on CT scan response at 2,000 cGY. Fifteen patients received whole-brain irradiation with a boost, one each with limited-field and whole-brain irradiation only. One patient with melanoma received craniospinal irradiation. Median pineal dose was 55 Gy; range, 50-60 Gy. Five treatment failures occurred, four local and one distant. Actuarial survival was 80%, 70%, and 65% at 5, 10, and 20 years. Median follow-up was 8.8 years. Cranial radiotherapy alone appears to control the majority of pineal tumors