Early adjuvant radiotherapy toward long-term survival and better quality of life for craniopharyngiomas--a study in single institute.
OBJECTIVE
The objective of the study is to compare survival and quality of life (QoL) by the delivery time of adjuvant radiotherapy (RT), early or late, for craniopharyngiomas.


METHODS
Fifty patients received RT between 1985 and 2002. Early RT (n=25) was delivered within 3 months after initial surgery, whereas late RT (n=25) was combined with or without reoperation after progression or relapse. Radiation dose ranged from 45 to 55.8 Gy with a median of 54 Gy. The median follow-up was 130 months.


RESULTS
Progression-free survival rates at 5 and 10 years were 95.9 and 91.2%, respectively. The overall or progression-free survival was not influenced by RT time. Initial tumor size was the only prognostic factor (p=0.034) for progression-free survival in univariate analysis. Better visual acuity or field was maintained, and diabetes insipidus was partly improved with early RT, but all were deteriorated as tumor progressed without early RT. Visual functions were not worsened after late RT.


CONCLUSIONS
The survival was excellent with adjuvant RT, early or late. Poor QoL with late RT resulted from relapsed tumor and repeated surgery but was not associated with RT itself. Thus, early RT with precision technique is highly recommended for better QoL and excellent survival, unless contraindicated.
Moon
Sung Ho
SH
Department of Radiation Oncology, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul, 110-744, South Korea.
Kim
Il Han
IH
Park
Seok Won
SW
Kim
Inah
I
Hong
Semie
S
Park
Charn Il
CI
Wang
Kyu Chang
KC
Cho
Byung Kyu
BK
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000473:pathology / Q000532:radiotherapy*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011183:Postoperative Complications; D011788:Quality of Life; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology