title: Interstitial radiotherapy using phosphorus-32 for giant posterior fossa cystic craniopharyngiomas.
abstract: OBJECTIVE
  The treatment for giant posterior fossa cystic craniopharyngiomas remains an important challenge in neurosurgery. The authors evaluated the effects of treating 20 patients with giant posterior fossa cystic craniopharyngiomas using phosphorus-32 (P-32) interstitial radiotherapy at their hospital.
  
  
  METHODS
  The patients included 11 boys and 9 girls with an age range of 3 to 168 months. Before treatment, the tumor volumes ranged from 65 to 215 ml. The intracranial pressure was increased in 16 patients, and optic nerve damage had occurred in 18. The patients received P-32 interstitial radiotherapy following stereotactic cyst-fluid aspiration or drainage and were followed up for 7-138 months.
  
  
  RESULTS
  The treatment immediately relieved the intracranial hypertension symptoms in all patients. At the end of follow-up, imaging examinations revealed that the cystic tumors had disappeared, but some residual calcification remained in 12 patients, and had decreased by more than 75% of the initial volume in 8 patients. The damaged optic nerve recovered in 3 cases, improved in 12 cases, remained unchanged in 1 case, and was aggravated in 2 cases. No other severe complications related to surgery or interstitial radiation occurred. During the follow-up period, 7 new cysts appeared in 5 patients who had received additional interstitial radiotherapies with a dose of P-32 that was calculated using the same formula as for the initial treatment. The new tumors then disappeared in 2 patients, significantly shrank in 2 patients, and progressed in 1 patient.
  
  
  CONCLUSIONS
  For treating giant posterior fossa cystic craniopharyngiomas, P-32 interstitial radiation after stereotactic cyst-fluid aspiration or drainage can achieve a high tumor control rate and has relatively satisfactory clinical effects and quality of life outcomes with few complications.
authors: Department of Neurosurgery, Navy General Hospital, Beijing;
authors: Xin
authors: X
authors: Yu
authors: Jianning
authors: J
authors: Zhang
authors: Rui
authors: R
authors: Liu
authors: Yaming
authors: Y
authors: Wang
authors: Hongwei
authors: H
authors: Wang
authors: Peng
authors: P
authors: Wang
authors: Jinhui
authors: J
authors: Chen
authors: Song
authors: S
authors: Liu
mesh_terms: D000293:Adolescent; D001918:Brachytherapy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000532:radiotherapy* / Q000601:surgery; D003560:Cysts / Q000601:surgery; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010761:Phosphorus Radioisotopes / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D011788:Quality of Life; D013238:Stereotaxic Techniques; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D010761:Phosphorus Radioisotopes
keywords: giant cystic craniopharyngioma; interstitial radiotherapy; oncology; phosphorus-32; stereotactic radiosurgery