Radiation therapy for pediatric craniopharyngioma.
OBJECTIVE
The treatment of craniopharyngioma is highly controversial. Continued advances in limited surgery and radiation therapy have maintained excellent local disease control while minimizing treatment-related sequelae. Further analyses of outcomes are necessary to characterize the long-term effects of radiation therapy.


METHODS
An extensive literature review was performed for all studies including radiation therapy, with or without surgery, for pediatric craniopharyngioma.


RESULTS
The authors identified 32 papers describing radiation therapy for treatment of pediatric craniopharyngioma, with disease control ranging from 44 to 100%. Modern studies report at least 90% disease control with 5-year follow-up. Fifteen studies reported outcomes, demonstrating that more than two-thirds of patients treated with surgery and radiation therapy have favorable outcomes, and this rate is more than 85% in the modern era.


CONCLUSIONS
Conservative surgery and radiation therapy results in long-term disease control in pediatric patients with craniopharyngioma that is comparable to results obtained with radical surgery alone. However, children with craniopharyngioma remain vulnerable to late treatment failures and side effects from radiation therapy, including endocrinopathies, vasculopathies, and secondary tumors, which may be detrimental to the quality of life. Long-term follow-up beyond 5-10 years is necessary to assess tumor control relative to functional outcomes.
Kiehna
Erin N
EN
Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.
Merchant
Thomas E
TE
D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D003397:Craniopharyngioma / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods; D017063:Outcome Assessment, Health Care; D010910:Pituitary Irradiation / Q000379:methods; D010911:Pituitary Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods*; D012658:Sella Turcica / Q000601:surgery; D016896:Treatment Outcome