Long-term outcome in children treated for craniopharyngioma with and without radiotherapy.
OBJECTIVE
The authors report the results of surgery alone or in combination with radiotherapy in the management of craniopharyngiomas in children.


METHODS
The authors retrospectively reviewed the outcomes in 31 patients treated for craniopharyngiomas at the Department of Radiation Oncology at Washington University in St. Louis and the St. Louis Children's Hospital. The median age at diagnosis was 8.1 years (range 1.1-21 years). Fourteen patients underwent gross-total resection (GTR) with observation, and 6 patients underwent subtotal resection (STR) with observation. Ten patients underwent STR or cyst aspiration followed by external-beam radiotherapy, and 1 patient underwent cyst aspiration followed by intracystic 32P installation.


RESULTS
The median follow-up for all surviving patients was 78.2 months. Overall survival and local control rates at 10 years were 96 and 58%, respectively. One patient died of the disease, and 12 patients had subsequent recurrences. Of those with recurrences, 6 patients had undergone initial STR with observation and 6 had been treated with GTR and observation. The median time to progression was 17.9 months in the patients who underwent limited resection, and 55 months for those who underwent GTR. There were no recurrences in the patients who received radiotherapy at the time of initial diagnosis.


CONCLUSIONS
Radiotherapy delivered as part of the initial management of craniopharyngiomas in children or at the time of recurrence provides effective local control.
Lin
Lilie L
LL
Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. lin@xrt.upenn.edu
El Naqa
Issam
I
Leonard
Jeffrey R
JR
Park
Tae Sung
TS
Hollander
Abby S
AS
Michalski
Jeff M
JM
Mansur
David B
DB
D000293:Adolescent; D000328:Adult; D001918:Brachytherapy; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010761:Phosphorus Radioisotopes / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D010761:Phosphorus Radioisotopes; D019275:Radiopharmaceuticals