Phosphorus-32 therapy for cystic craniopharyngiomas.
OBJECTIVE
To examine control rates for predominantly cystic craniopharyngiomas treated with intracavitary phosphorus-32 (P-32).


METHODS
22 patients with predominantly cystic craniopharyngiomas were treated at Indiana University between October 1997 and December 2006. Nineteen patients with follow-up of at least 6 months were evaluated. The median patient age was 11 years, median cyst volume was 9 ml, a median dose of 300 Gy was prescribed to the cyst wall, and median follow-up was 62 months.


RESULTS
Overall cyst control rate after the initial P-32 treatment was 67%. Complete tumor control after P-32 was 42%. Kaplan-Meier 1-, 3-, and 5-year initial freedom-from-progression rates were 68%, 49%, and 31%, respectively. Following salvage therapy, the Kaplan-Meier 1-, 3-, and 5-year ultimate freedom-from-progression rates were 95%, 95%, and 86%, respectively. All patients were alive at the last follow-up. Visual function was stable or improved in 81% when compared prior to P-32 therapy. Pituitary function remained stable in 74% of patients following P-32 therapy.


CONCLUSIONS
Intracystic P-32 can be an effective and tolerable treatment for controlling cystic components of craniopharyngiomas as a primary treatment or after prior therapies, but frequently allows for progression of solid tumor components. Disease progression in the form of solid tumor progression, re-accumulation of cystic fluid, or development of new cysts may require further radiotherapy or surgical intervention for optimal long-term disease control.
Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Robert Bryan
RB
Barriger
Andrew
A
Chang
Simon S
SS
Lo
Robert D
RD
Timmerman
Colleen
C
DesRosiers
Joel C
JC
Boaz
Achilles J
AJ
Fakiris
D000293:Adolescent; D000328:Adult; D001918:Brachytherapy; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000401:mortality / Q000532:radiotherapy*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010761:Phosphorus Radioisotopes / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000401:mortality / Q000532:radiotherapy*
D010761:Phosphorus Radioisotopes