title: Fractionated stereotactic radiotherapy for craniopharyngiomas.
abstract: OBJECTIVE
  To investigate outcome and toxicity after fractionated stereotactic radiation therapy (FSRT) in patients with craniopharyngiomas.
  
  
  METHODS
  Twenty-six patients with craniopharyngiomas were treated with FSRT between May 1989 and February 2001. Median age was 33.5 years (range: 5-57 years). Nine patients received FSRT after surgery as primary treatment, and 17 patients were irradiated for recurrent tumor or progressive growth after initial surgery. Median target dose was 52.2 Gy (range: 50.0-57.6 Gy) with conventional fractionation. Follow-up included MRI and neurologic, ophthalmologic, and endocrinologic examinations.
  
  
  RESULTS
  The median follow-up was 43 months (range: 7-143 months). The actuarial local control rate and actuarial overall survival rates were 100% and 100%, respectively, at 5 years and 100% and 83%, respectively, at 10 years. Four patients showed complete response, 14 patients showed partial response, and 8 patients remained stable. In 5 patients, vision improved after radiation therapy. Acute toxicity was mild. One patient required cyst drainage 3 months after radiotherapy. Late toxicity after radiotherapy included impairment of hormone function in 3 out of 18 patients at risk. We did not observe any vision impairment, radionecrosis, or secondary malignancies.
  
  
  CONCLUSIONS
  FSRT is effective and safe in the treatment of cystic craniopharyngiomas. Toxicity is extremely low using this conformal technique.
authors.affiliation: Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany. d.ertner@dkfz.de
authors.forename: Daniela
authors.initials: D
authors.lastname: Schulz-Ertner
authors.forename: Claudia
authors.initials: C
authors.lastname: Frank
authors.forename: Klaus K
authors.initials: KK
authors.lastname: Herfarth
authors.forename: Bernhard
authors.initials: B
authors.lastname: Rhein
authors.forename: Michael
authors.initials: M
authors.lastname: Wannenmacher
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000532:radiotherapy*; D011878:Radiotherapy / Q000379:methods*; D013238:Stereotaxic Techniques