Craniopharyngioma: treatment in the CT and MR imaging era.

Mark, Rufus J.; Lutge, W R; Shimizu, K; Tran, L M; Selch, Michael T.; Parker, R. G.

doi:10.1148/radiology.197.1.7568823

Cited by 48 publications

(15 citation statements)

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“…This same study also reported a 3.9% mortality rate associated with extirpation. Mark et al 24 reported a 10% mortality rate at 5 years and a severe surgical morbidity rate of 16%. These authors further reported that all patients who had undergone complete resection had worsened functional status after surgery and that all patients in whom resection was attempted had worsened pituitary function.…”

Section: Resection For Craniopharyngiomasmentioning

confidence: 99%

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Evaluation of the role of Gamma Knife surgery in the treatment of craniopharyngiomas

Gopalan

Dassoulas²,

Rainey³

et al. 2008

FOC

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✓ The management of craniopharyngioma involves balancing adequate reduction in tumor volume and prevention of recurrence while minimizing damage to delicate surrounding structures. Because of the lesion's proximity to the optic chiasm and its relationship to the hypothalamic–pituitary axis, morbidity rates following treatment can be high. Gamma Knife surgery (GKS) is now being considered as a viable method of providing tumor control while ensuring minimal side effects. The authors conducted a literature review of 10 studies in which GKS was used to treat craniopharyngioma; some lesions had been previously treated and some had not. The mean marginal dose ranged from 5 to 16.4 Gy (mean 12.3 Gy). Tumor control was achieved in 75% of cases overall and varied with tumor subtype (cystic, solid, mixed). Control was seen in 90% of solid, 80% of cystic, and 59% of mixed tumors. The overall morbidity rate resulting from radiosurgery was 4% and the overall mortality rate was 0.5%. These results suggest that GKS may provide a favorable benefit-to-risk profile for many patients with craniopharyngiomas.

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Section: Resection For Craniopharyngiomasmentioning

confidence: 99%

“…24 Prasad et al 30 reviewed results of surgical treatment for craniopharyngioma published between 1966 and 1994 and reported that only 35.5% of these surgical series for craniopharyngioma achieved a radical resection of Ͼ 50% and that even when radical resection was accomplished, tumors recurred in…”

Section: Resection For Craniopharyngiomasmentioning

confidence: 99%

Evaluation of the role of Gamma Knife surgery in the treatment of craniopharyngiomas

Gopalan

Dassoulas²,

Rainey³

et al. 2008

FOC

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“…Treatment remains controversial, as some surgeons advocate aggressive surgical resection [8][9][10][11][12], and others favor conservative or limited surgical treatment [13][14][15][16]. Debate also continues regarding the optimal surgical ap proach for resection.…”

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confidence: 99%

Neurobehavioral Outcome in Pediatric Craniopharyngioma

et al. 1997

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Neurobehavioral dysfunction occurs in children with craniopharyngioma, both before and after treatment, and its impact on outcome may not be fully appreciated. Also unclear is whether neurobehavioral outcome relates more to tumor location or surgical factors. We reviewed the records of 20 children with craniopharyngioma who were seen between 1983 and 1995. All children had subfrontal craniotomy and either partial (14 children) or gross total (6 children) resection of their tumors. In addition to traditional neuropsychological testing, we assessed social behavior and school performance using standardized ratings based on family interviews and school records. Over a mean follow-up period of 38 months, only 3 of 20 children had a good outcome in all three categories, and 12 of 20 had moderate or severe impairment in at least one category. Outcome did not differ between those who had partial and those with gross total resection. We conclude that neurobehavioral disorders are common and cause important morbidity in children after treatment for craniopharyngioma. To evaluate these impairments in future outcome studies, standard neuropsychological testing should be supplemented by specific behavioral assessments to capture the full range of neurobehavioral disability. In this series, partial versus gross total resection did not influence outcome, implying that tumor location in diencephalic and limbic regions is a more important factor.

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“…An overview of published reports indicates an average of 12% (range, 2%-43%) risk of operative mortality and 30% (range, 12%-61%) incidence of severe morbidity. Morbidity includes the risk of disabling hypothalamic damage (40%) and visual impairment (19%) (Mark et al, 1995). Residual tumors generally progress within several years.…”

Section: Microsurgical Resectionmentioning

confidence: 99%

Stereotactic radiosurgery of residual or recurrent craniopharyngioma, after surgery, with or without radiation therapy

Chiou¹,

Lunsford²,

Niranjan³

et al. 2001

Neuro-Oncol

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Neuro-Oncology n J U LY 2 0 0 1 159 This study evaluated the role of stereotactic radiosurgery in the multimodality management of craniopharyngioma patients whose prior therapies failed. Ten consecutive patients (3 males and 7 females) had radiosurgery for craniopharyngioma during a 10-year interval. Their ages ranged from 9 to 64 years (median, 14.5 years). The median interval between diagnosis and radiosurgery was 46.5 months. In total, 12 stereotactic radiosurgical procedures were performed to control the solid component of the tumor (2 intrasellar and 10 suprasellar tumors). The median tumor volume was 1.35 cm 3 . One to 9 isocenters with different beam diameters were used; the median marginal dose was 16.4 Gy; and the dose to the optic apparatus was limited to less than 8 Gy. Clinical and imaging follow-up data were obtained at a median of 63 months (range, 13-150 months) from radiosurgery. Overall, 7 of 12 tumors became smaller or vanished within a median of 8.5 months. Prior visual defects objectively improved in 6 patients. One patient with prior visual defect deteriorated further and lost vision 9 months after radiosurgery. Multimodality therapy is often necessary for patients with refractory solid and cystic craniopharyngiomas. Stereotactic radiosurgery is a reasonable option in select patients with small recurrent or residual craniopharyngioma. Neuro-Oncology 3, 159-166, 2001 (Posted to Neuro-Oncology [serial online], Doc. 00-049, May 7, 2001

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Craniopharyngioma: treatment in the CT and MR imaging era.

Abstract: RT achieves excellent tumor control after subtotal resection of craniopharyngiomas.

Cited by 48 publications

References 0 publications

Evaluation of the role of Gamma Knife surgery in the treatment of craniopharyngiomas

Evaluation of the role of Gamma Knife surgery in the treatment of craniopharyngiomas

Neurobehavioral Outcome in Pediatric Craniopharyngioma

Stereotactic radiosurgery of residual or recurrent craniopharyngioma, after surgery, with or without radiation therapy

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