Craniopharyngiomas: intratumoral chemotherapy with interferon-α: a multicenter preliminary study with 60 cases

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>The authors assessed the efficacy of intratumoral interferon-α (IFNα)–based chemotherapy in pediatric patients with cystic craniopharyngiomas.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>In a prospective multicenter study of 60 pediatric patients, the authors assessed the efficacy of intratumoral INFα2A-based chemotherapy. The study was conducted between 2000 and 2009 at 3 locations: the Medical School of the Federal University of São Paulo, Catholic University of Rome, and the Neurosurgery Institute of Santiago, Chile. The assessment included clinical and radiological control examinations, side effects observed, and total dose used.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Sixty cases of cystic craniopharyngioma were analyzed. The cohort consisted of 35 male and 25 female children (mean age 11 years). Clinical and radiological improvement was achieved in 76% of the cases. New endocrinological deficits were observed in 13% of the cases. In approximately 30% of the patients, the evolution included some light side effects, the most common being headache (33%) and eyelid edema (28%). The number of cycles varied from 1 to 9 (mean 5 cycles), and the total dose applied per cycle was 36,000,000 IU.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>This has been the largest documented series of intratumoral chemotherapy using INFα for the control of cystic craniopharyngiomas. The treatment has proved efficacious; there was no mortality, and morbidity rates were low.</jats:p></jats:sec>

Cyst Wall Calcification Following Intracavitary Alpha Interferon Chemotheraphy for a Huge Cystic Craniopharyngioma in a Child: Case Report

“…However, none of them required the discontinuation of treatment. 13 The major advantage of IFNα is to be nonneurotoxic and does not appear any significant complication even if it spills into the subarachnoid space. It was also emphasized that tumor was less adherent than a typical craniopharyngioma after IFNα treatment, making resection easier (unlike bleomycine).…”

“…In 2010, a multicenter study of 60 pediatric patients revealed the clinical and radiological improvement in 76% of the cases in an average follow-up duration of 44 months. 13 IFNα applications are carried out via an Ommaya reservoir connected to a silicone catheter. Intratumoral catheter could be placed to the cyst cavity in various ways such as; frontal craniotomy and subfrontal microsurgical access, neuroendoscopic transventricular fenestration of the cyst or direct frontal puncture for extensive lesions.…”

Intracystic interferon-α treatment leads to neurotoxicity in craniopharyngioma: case report

“…2,9 Interferona has become an attractive alternative with similar effectiveness but without severe neurotoxicity. 3,4,10 This drug is believed to act through the Fasmediated apoptotic pathway but also has immunomodulatory, antiproliferative, and antiangio genic activities. 10 The standard dose is 3 million IU in jected every other day (3 times a week) for 4 weeks.…”

“…10 The standard dose is 3 million IU in jected every other day (3 times a week) for 4 weeks. 4 Patients often receive several cycles of therapy, de pending on their response to treatment. Before injecting the medication, a contrast injection test is done after the catheter is implanted to determine if any leakage is pres ent.…”

“…16 Interferon (IFN)a has been gaining popularity as an intracystic therapy for craniopharyngioma as a result of its efficacy and supposed benign toxicity profile. 4 How ever, in the current case report we describe a patient who, while receiving intracystic IFNa, suffered a neurological event, which was believed to be related to drug leakage outside the cyst. It is the first report of a focal neurological deficit potentially attributable to intracystic IFN-a therapy, highlighting the fact that IFNa may have neurotoxic ef fects on the central nervous system.…”