title: Experience of external beam radiotherapy given adjuvantly or at relapse following surgery for craniopharyngioma.
abstract: OBJECTIVE
  Evaluation of effect of timing of external beam radiation therapy (EBRT) following surgery for craniopharyngioma.
  
  
  METHODS
  Between 1976 and 2002, 87 patients (28 children) received EBRT in a regional referral centre. Forty-four patients received EBRT adjuvantly and 43 on relapse. The median total dose was 42.5Gy (range 34.7-52.5Gy) in 2.25-2.83Gy fractions over a median of 20 days (range 17-32). Effect of EBRT timing, type of original surgery, age on survival, progression-free survival (PFS) and quality of life (QOL) was studied.
  
  
  RESULTS
  Survival from diagnosis was 86 and 76% and PFS was 78 and 66% at 10 and 20 years, respectively, with no significant difference seen between those treated adjuvantly or at relapse or according to age. QOL deteriorated significantly from diagnosis to last follow-up. Excluding patients who relapsed following EBRT, QOL did not deteriorate significantly overall (P=0.35). Children had worse QOL and greater morbidity at all timepoints compared to adults.
  
  
  CONCLUSIONS
  EBRT is effective both adjuvantly and at relapse. QOL deteriorates over time-relapse following EBRT was the only significant factor. Children have greater morbidity compared to adults, but no evidence for greater EBRT-induced toxicity was seen.
authors.affiliation: Department of Clinical Oncology, Christie Hospital, Withington, UK.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Pemberton
authors.forename: Mark
authors.initials: M
authors.lastname: Dougal
authors.forename: Brian
authors.initials: B
authors.lastname: Magee
authors.forename: H Rao
authors.initials: HR
authors.lastname: Gattamaneni
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003397:Craniopharyngioma / Q000532:radiotherapy* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D010911:Pituitary Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013997:Time Factors