{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:57:34Z","timestamp":1781643454614,"version":"3.54.5"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018719","name":"Koc University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018719","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurosurg Rev"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pilocytic astrocytoma (PA) is a WHO grade I glioma with generally favorable outcomes; however, deep or eloquent tumor locations often limit safe gross total resection. Gamma Knife radiosurgery (GKRS) has emerged as a minimally invasive alternative for residual or recurrent disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A retrospective review of 88 patients (60 diagnosed in childhood and 28 in adulthood) treated with GKRS between 2008 and 2024 was conducted. Clinical, radiological, and treatment parameters were analyzed. PFS was assessed with Kaplan\u2013Meier analysis, and predictive factors were identified using univariate and multivariate Cox regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median follow-up was 36 months. Pediatric patients showed 5- and 10-year PFS rates of 84.7% and 66.7%, while adults demonstrated 81.7% at both time points. Multivariate analysis identified prior radiotherapy as the only independent predictor of recurrence in the entire cohort, with significant impact also observed in the pediatric subgroup. Cystic\/mixed morphology increased recurrence risk in pediatric patients, while no independent predictors were identified in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion<\/jats:title>\n                    <jats:p>GKRS provides durable long-term tumor control in both pediatric and adult PA patients. Prior radiotherapy consistently predicts poorer PFS, underscoring its importance in treatment planning. In pediatric patients, tumor morphology also influences outcomes. Despite the retrospective design and cohort heterogeneity, this represents one of the largest single-center GKRS series and supports GKRS as a safe and effective modality for PA management. Prospective studies are needed to refine patient selection and optimize therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10143-026-04209-w","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T04:10:49Z","timestamp":1774066249000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stereotactic radiosurgery for pilocytic astrocytoma: A single center retrospective study"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3010-6132","authenticated-orcid":false,"given":"Sukran","family":"Senyurek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5300-2347","authenticated-orcid":false,"given":"Ilayda","family":"Kayir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8323-8932","authenticated-orcid":false,"given":"Dogu Cihan","family":"Yildirim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2535-9832","authenticated-orcid":false,"given":"Ali Haluk","family":"Duzkalir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7126-6373","authenticated-orcid":false,"given":"Mehmet Orbay","family":"Askeroglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3057-3355","authenticated-orcid":false,"given":"Selcuk","family":"Peker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,21]]},"reference":[{"issue":"9","key":"4209_CR1","doi-asserted-by":"publisher","first-page":"2453","DOI":"10.1007\/s00701-022-05301-y","volume":"164","author":"SH Torp","year":"2022","unstructured":"Torp SH, Solheim O, Skjulsvik AJ (2022) The WHO 2021 Classification of Central Nervous System tumours: a practical update on what neurosurgeons need to know-a minireview. Acta Neurochir (Wien) 164(9):2453\u20132464","journal-title":"Acta Neurochir (Wien)"},{"issue":"8","key":"4209_CR2","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1093\/neuonc\/noab106","volume":"23","author":"DN Louis","year":"2021","unstructured":"Louis DN et al (2021) The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol 23(8):1231\u20131251","journal-title":"Neuro Oncol"},{"key":"4209_CR3","unstructured":"Knight J, Karsonovich T, De Jesus O Pilocytic Astrocytoma, in StatPearls. 2025: Treasure Island (FL) ineligible companies. Disclosure: Torin Karsonovich declares no relevant financial relationships with ineligible companies. Disclosure: Orlando De Jesus declares no relevant financial relationships with ineligible companies"},{"issue":"2","key":"4209_CR4","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1007\/s11060-009-9913-5","volume":"95","author":"H Kano","year":"2009","unstructured":"Kano H et al (2009) Stereotactic radiosurgery for pilocytic astrocytomas part 1: outcomes in adult patients. J Neurooncol 95(2):211\u2013218","journal-title":"J Neurooncol"},{"issue":"2","key":"4209_CR5","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2012.12.FOCUS12343","volume":"34","author":"JH Bagley","year":"2013","unstructured":"Bagley JH et al (2013) Improved survival in the largest national cohort of adults with cerebellar versus supratentorial low-grade astrocytomas. Neurosurg Focus 34(2):E7","journal-title":"Neurosurg Focus"},{"issue":"1","key":"4209_CR6","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s11060-012-0829-0","volume":"108","author":"DR Johnson","year":"2012","unstructured":"Johnson DR et al (2012) Pilocytic astrocytoma survival in adults: analysis of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. J Neurooncol 108(1):187\u2013193","journal-title":"J Neurooncol"},{"issue":"3","key":"4209_CR7","doi-asserted-by":"publisher","first-page":"2789","DOI":"10.3892\/ol.2017.6543","volume":"14","author":"J Spitaels","year":"2017","unstructured":"Spitaels J et al (2017) Management of supratentorial recurrent low-grade glioma: A multidisciplinary experience in 35 adult patients. Oncol Lett 14(3):2789\u20132795","journal-title":"Oncol Lett"},{"issue":"2","key":"4209_CR8","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s11060-009-9912-6","volume":"95","author":"H Kano","year":"2009","unstructured":"Kano H et al (2009) Stereotactic radiosurgery for pilocytic astrocytomas part 2: outcomes in pediatric patients. J Neurooncol 95(2):219\u2013229","journal-title":"J Neurooncol"},{"issue":"1","key":"4209_CR9","doi-asserted-by":"publisher","first-page":"162","DOI":"10.3171\/2019.9.JNS191335","volume":"134","author":"ES Murphy","year":"2021","unstructured":"Murphy ES et al (2021) Outcomes of stereotactic radiosurgery for pilocytic astrocytoma: an international multiinstitutional study. J Neurosurg 134(1):162\u2013170","journal-title":"J Neurosurg"},{"issue":"6","key":"4209_CR10","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/S1470-2045(11)70057-2","volume":"12","author":"MJ van den Bent","year":"2011","unstructured":"X, van den Bent MJ, Wefel JS, Schiff D et al (2011) Response assessment in neuro-oncology (RANO) criteria for low-grade gliomas. Lancet Oncol 12(6):583\u2013593","journal-title":"Lancet Oncol"},{"issue":"1","key":"4209_CR11","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1007\/s11060-023-04277-8","volume":"162","author":"Z Wei","year":"2023","unstructured":"Wei Z et al (2023) Radiosurgery outcomes in infratentorial juvenile pilocytic astrocytomas. 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Ethical approval (Approval Number: 2022. 022.IRB1.017) was obtained from the Ko\u00e7 University Institutional Review Board (IRB). The study included only patients who had provided informed consent at the initiation of treatment permitting the use of their data for academic and scientific purposes; therefore, additional informed consent was waived due to the retrospective nature of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}}],"article-number":"296"}}