title: Intratumoral therapy with bleomycin for cystic craniopharyngiomas in children.
abstract: Surgical removal of cystic craniopharyngiomas in children is associated with significant operative morbidity and recurrence rates. The purpose of this study was to review our experience with a less invasive therapy, namely, intratumoral bleomycin, in the treatment of predominantly cystic craniopharyngiomas. All children with craniopharyngiomas treated at a tertiary care pediatric neurosurgical center since 1994, when bleomycin was first used, were reviewed retrospectively. Seven patients received intratumoral bleomycin therapy. Patients received 2-5 mg bleomycin per dose, 3 times per week, for 3-5 weeks as an initial course. Mean follow-up of these patients was 3 years. In 4 patients, treatment resulted in a significant decrease (>50%) in tumor size, which has remained stable. Two patients' tumors progressed and underwent resection, and 1 patient had surgical removal because of persistent headaches, although no growth of residual tumor had been noted. One patient developed peritumoral edema as a result of bleomycin therapy. Intratumoral bleomycin is a useful alternative therapy for cystic craniopharyngiomas, and may control tumor growth and delay potentially harmful resection and/or radiotherapy in young children.
authors: Division of Neurosurgery, Department of Surgery, B.C.'s Children's Hospital, Vancouver, British Columbia, Canada.
authors: W J
authors: WJ
authors: Hader
authors: P
authors: P
authors: Steinbok
authors: J
authors: J
authors: Hukin
authors: C
authors: C
authors: Fryer
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D001761:Bleomycin / Q000008:administration & dosage*; D001929:Brain Edema; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000188:drug therapy* / Q000473:pathology; D003560:Cysts / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D008297:Male; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin