The therapeutic efficacy of fractionated radiotherapy and gamma-knife radiosurgery for craniopharyngiomas.
There is no consensus regarding the optimal timing of radiation treatment (RT) for residual or recurrent craniopharyngioma or the preferred treatment modality between fractionated radiotherapy (FRT) and gamma-knife radiosurgery (GKRS) in terms of morbidity and efficacy. This study aims to clarify the optimal timing of RT for residual or recurrent tumors by analyzing the outcomes of RT as a salvage or adjunctive treatment, and to compare the therapeutic efficacy of FRT and GKRS. Between April 1995 and November 2009, 50 of 129 patients received RT for recurrent or residual tumors. The patients were analyzed for medical data, endocrine outcome, long-term morbidity and mortality rates, recurrence rates, and responses to adjuvant RT and GKRS. Mean progression-free survival was 92.5 months (95% confidence interval, 70.9-114.1 months). Univariate analysis revealed that pre-irradiation tumor volume was closely related to better prognosis (p=0.01). We found that there was no significant difference in recurrence between patients treated with adjuvant compared to salvage RT (p>0.05). Although we found no difference in the efficacy of FRT and GKRS, five patients were newly diagnosed with hypopituitarism following RT. We concluded that RT has a very high rate of tumor control after both adjuvant or salvage RT. This study highlights the relative safety and efficacy of FRT and GKRS.
Pusan National University School of Medicine, Busan, South Korea.
Chiman
C
Jeon
Sejin
S
Kim
Hyung Jin
HJ
Shin
Do-Hyun
DH
Nam
Jung-Il
JI
Lee
Kwan
K
Park
Jong Hyun
JH
Kim
ByungChan
B
Jeon
Doo-Sik
DS
Kong
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003397:Craniopharyngioma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D016634:Radiosurgery / Q000009:adverse effects / Q000295:instrumentation*; D012008:Recurrence; D016896:Treatment Outcome