Peripheral neural crest tumor brain metastases management: a single-institution retrospective study.

OBJECTIVE

Brain metastases (BM) of peripheral neural crest tumors (PNCTs) are rare and bear a poor prognosis. Only a small number of prior studies document treatment of PNCT BM, with outcomes of stereotactic radiosurgery (SRS) limited to case reports. This study aimed to evaluate the efficacy and safety of SRS for PNCT BM, comparing it with alternative treatment approaches.

METHODS

We retrospectively reviewed patients treated for PNCT at our institution between 2001 and 2024. Demographic, clinicopathologic, and treatment data were collected. Survival outcomes were estimated using Kaplan-Meier analysis. Local tumor control (LTC), progression-free survival (PFS), and overall survival (OS) rates were analyzed for the SRS-group and non-SRS cohort.

RESULTS

We identified 8 patients with PNCTs, with a total of 15 BM treated during the study period. Of these, 3 patients with 6 tumors underwent SRS, and 5 patients with 9 tumors received radiotherapy, craniotomy, or chemotherapy. The SRS cohort had a LTC rate of 100%, with an OS of 33.3% at 1-year follow up. Mean OS was 20.7 months (95% CI, 0–46.6). LTC in the group treated with other modalities was 71%, with an OS of 60% at 1-year follow up. Mean OS was 56.2 months (95% CI, 17.8–94.6).

CONCLUSION

SRS provided excellent local control of PNCT BM at 1-year follow-up without significant adverse radiation effects, supporting its potential as a viable minimally invasive option, especially for patients at higher risk from surgery or conventional radiotherapy. Larger prospective studies are needed to clarify the role of SRS in this rare population.