The role of fractionated radiotherapy and radiosurgery in the management of patients with craniopharyngioma.
The optimal management of craniopharyngiomas remains controversial. The first-line treatment usually consists of surgical resection. Complete tumor removal provides a high rate of long-term control; however, aggressive surgery is associated with significant incidence of complications. Radiotherapy (RT) is currently used in patients after limited surgery and achieves excellent long-term tumor control. Stereotactic radiotherapy, both in the form of radiosurgery (RS) or fractionated stereotactic radiotherapy (FSRT), has been developed as a more accurate technique of irradiation with more precise tumor localization and consequently a reduction in the volume of normal brain irradiated to high radiation doses. We provide a review of published data on outcome of conventional fractionated RT and modern radiation techniques. FSRT is a suitable treatment technique for all sizes of craniopharyngiomas, and efficacy is comparable to conventional RT. Single-fraction stereotactic radiosurgery is usually delivered to small tumors away from critical structures. Longer follow-up is necessary to confirm the excellent tumor control and the potential reduction of long-term radiation toxicity.
Minniti
G
G
Department of Radiotherapy Oncology, Sant' Andrea Hospital, University La Sapienza, Via di Grottarossa 1035, 00189, Rome, Italy. Giuseppe.Minniti@ospedalesantandrea.it
Esposito
V
V
Amichetti
M
M
Enrici
R Maurizi
RM
D003397:Craniopharyngioma / Q000532:radiotherapy* / Q000601:surgery*; D019583:Dose Fractionation, Radiation; D006801:Humans; D010911:Pituitary Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome