title: Long-term outcomes for adult craniopharyngioma following radiation therapy.
abstract: BACKGROUND
  We report long-term outcomes in adult patients with craniopharyngioma following surgery and radiation therapy (RT).
  
  
  METHODS
  Fifty-three patients treated with RT (median, 50 Gy in 25 fractions) between 1980 and 2009 with pathologically confirmed craniopharyngioma were reviewed (53% solid and 47% cystic/solid). The median age was 53 years (range, 22-76), 53% were female, 83% were sub-totally resected, 6% were gross totally resected and 11% had a biopsy and/or cyst aspiration alone. RT was delivered adjuvantly in 53% of patients as opposed to salvage intent upon progression.
  
  
  RESULTS
  Median follow-up was seven years (86 months, range, 8-259). The 5- and 10-year progression-free survival (PFS) rates were 85% and 69%, overall survival (OS) rates were 76% and 70%, and cause-specific survival (CSS) rates were both 88%, respectively. Both univariable and multivariable analysis identified age (<53 or ≥53) as a prognostic factor for OS (p =0.0003) and CSS (p =0.05). PFS was observed to be worse in patients with >2 surgeries prior to RT (p =0.01). Neither the intent of radiation or tumor type (cystic vs. solid/cystic) were prognostic or predictive. New endocrinopathies and visual dysfunction were observed in 53% and 17% of patients post-surgery, and in 11% and 6% post-RT, respectively.
  
  
  CONCLUSIONS
  We report long-term favorable PFS, CSS and OS for craniopharyngioma post-RT. We observe age as a significant prognostic factor, however, timing of radiation was not.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Laurence
authors.initials: L
authors.lastname: Masson-Cote
authors.forename: Giuseppina Laura
authors.initials: GL
authors.lastname: Masucci
authors.forename: Eshetu G
authors.initials: EG
authors.lastname: Atenafu
authors.forename: Barbara-Ann
authors.initials: BA
authors.lastname: Millar
authors.forename: Michael
authors.initials: M
authors.lastname: Cusimano
authors.forename: Sidney
authors.initials: S
authors.lastname: Croul
authors.forename: Warren
authors.initials: W
authors.lastname: Mason
authors.forename: Normand J
authors.initials: NJ
authors.lastname: Laperriere
authors.forename: Arjun
authors.initials: A
authors.lastname: Sahgal
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003397:Craniopharyngioma / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010911:Pituitary Neoplasms / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D055815:Young Adult