title: Outcome of postoperative intratumoral bleomycin injection for cystic craniopharyngioma.
abstract: Total excision is a treatment of choice in preventing the relapse of craniopharyngioma, but for tumors involving an extensive area, it is often associated with an increased risk of complications. We have performed a partial or subtotal tumor removal followed by repeated injection of bleomycin into the remaining tumor through a subcutaneous reservoir as postoperative adjuvant therapy. A retrospective review of clinical, radiological, and surgical data was performed for 10 patients (5 males and 5 females; age, 3-65 yr; follow-up duration, 12-79 months) with cystic craniopharyngiomas. The measurements of lactate dehydrogenase (LDH) level at each aspiration were performed. The shrinkage and/or stabilization of tumor was initially noted in all cases. The recurrence of tumor was seen in 4 cases (40%). The decreased or increased level of LDH was interpreted as tumor shrinkage or recurrence, respectively. The transient toxic reactions were observed in 3 patients (30%). Our study demonstrates that postoperative bleo-mycin injection for cystic craniopharyngioma, although does not appear to eradicate the tumor, decreases and stabilizes the tumor size, when used as an adjuvant therapy in young patients.
authors.affiliation: Department of Neurosurgery, College of Medicine, Korea University, Seoul, Korea. jypark@kumc.or.kr
authors.forename: Dong Hyuk
authors.initials: DH
authors.lastname: Park
authors.forename: Jung Yul
authors.initials: JY
authors.lastname: Park
authors.forename: Joo Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Yong Gu
authors.initials: YG
authors.lastname: Chung
authors.forename: Hoon Kap
authors.initials: HK
authors.lastname: Lee
authors.forename: Ki Chan
authors.initials: KC
authors.lastname: Lee
authors.forename: Jung Keun
authors.initials: JK
authors.lastname: Suh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001921:Brain / Q000528:radiation effects; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D011182:Postoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin; D007770:L-Lactate Dehydrogenase