Fractionated stereotactic radiotherapy for craniopharyngiomas

Schulz-Ertner, Daniela; Frank, Claudia; Herfarth, Klaus; Rhein, B.; Wannenmacher, M.; Debus, Jürgen

doi:10.1016/s0360-3016(02)03029-8

Cited by 88 publications

(48 citation statements)

References 27 publications

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“…In contrast, no radiation-induced optic neuropathies were observed after FSRT of craniopharyngiomas in a retrospective study by Selch et al [12], a study by Schulz-Ertner et al of 26 patients [4], and a subsequent study by the same group and extended cohort of 40 patients [3]. Finally, Kanesaka et al, in a retrospective study, also did not observe visual deterioration in any of their 16 patients [10].…”

Section: Discussionmentioning

confidence: 89%

“…These studies have consistently reported favorable tumor control, but conflicting results in terms of risks and side effects concerning vision and endocrine function after FSRT [3,4,[10][11][12][13][14]. We now report our findings in a prospective cohort of 16 consecutively treated adult patients with craniopharyngiomas, treated over a 17-year period with FSRT, regarding visual outcome, endocrine function, and tumor control.…”

mentioning

confidence: 78%

“…They are usually benign epithelial tumors believed to originate from remnants of the Rathke's pouch, and are either localized in the sellar or suprasellar region and can be cystic or solid, or both [3]. Presenting symptoms include visual loss and endocrine disturbances [2,4]. Initial treatment is most often surgical [2,5,6].…”

mentioning

confidence: 99%

“…There have been several published studies of the results of FSRT for craniopharyngiomas, consisting of smaller [10][11][12] or larger cohorts [3,4,13,14]. These studies have consistently reported favorable tumor control, but conflicting results in terms of risks and side effects concerning vision and endocrine function after FSRT [3,4,[10][11][12][13][14].…”

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confidence: 99%

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Visual outcome, endocrine function and tumor control after fractionated stereotactic radiation therapy of craniopharyngiomas in adults: findings in a prospective cohort

et al. 2017

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Background: The purpose of this study was to examine visual outcome, endocrine function and tumor control in a prospective cohort of craniopharyngioma patients, treated with fractionated stereotactic radiation therapy (FSRT). Material and methods: Sixteen adult patients with craniopharyngiomas were eligible for analysis. They were treated with linear accelerator-based FSRT during 1999-2015. In all cases, diagnosis was confirmed by histological analysis. The prescription dose to the tumor was 54 Gy (median, range 48-54) in 1.8 or 2.0 Gy per fraction, and the maximum radiation dose to the optic nerves and chiasm was 54.2 Gy (median, range 48.6-60.0) for the cohort. Serial ophthalmological and endocrine evaluations and magnetic resonance imaging (MRI) scans were performed at regular intervals. Median followup was 3.3 years (range 1.1-14.1), 3.7 years (range 0.8-15.2), and 3.6 years (range 0.7-13.1) for visual outcome, endocrine function, and tumor control, respectively. Results: Visual acuity impairment was present in 10 patients (62.5%) and visual field defects were present in 12 patients (75%) before FSRT. One patient developed radiation-induced optic neuropathy at seven years after FSRT. Thirteen of 16 patients (81.3%) had pituitary deficiency before FSRT, and did not develop further pituitary deficiency after FSRT. Mean tumor volume pre-FSRT was 2.72 cm 3 (range 0.20-9.90) and post-FSRT 1.2 cm 3 (range 0.00-13.10). Tumor control rate was 81.3% at two, five, and 10 years after FSRT. Conclusions: FSRT was relatively safe in this prospective cohort of craniopharyngiomas, with only one case of radiation-induced optic neuropathy and no case of new endocrinopathy. Tumor control rate was acceptable.

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Section: Discussionmentioning

confidence: 89%

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confidence: 78%

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confidence: 99%

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confidence: 99%

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Visual outcome, endocrine function and tumor control after fractionated stereotactic radiation therapy of craniopharyngiomas in adults: findings in a prospective cohort

et al. 2017

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“…Long-term results are still needed to see if stereotactic radiotherapy will indeed decrease the risk of damage to the surrounding structures and improve functional outcome. 26,43,44 Stereotactic radiosurgical treatment of craniopharyngiomas is typically limited to tumors 3 cm or smaller that are 3-5-mm away from the optic chiasm and nerves. The authors of several studies have reported safe and effective long-term results with the Gamma Knife in the treatment of craniopharyngiomas.…”

Section: Stereotactic Radiosurgery and Radiotherapymentioning

confidence: 99%

Radiation therapy and CyberKnife radiosurgery in the management of craniopharyngiomas

Lee¹,

Kalani²,

Cheshier³

et al. 2008

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Object Many benign intracranial tumors are amenable to radiotherapy treatment including meningiomas, schwannomas, pituitary tumors, and craniopharyngiomas. The authors present their experience in the treatment of craniopharyngiomas in 16 patients using frameless CyberKnife stereotactic radiosurgery (SRS). The authors discuss the role of radiation therapy in the management of these tumors, and more specifically, the role of CyberKnife SRS. Methods Sixteen patients were treated for residual or recurrent craniopharyngioma between 2000 and 2007 with CyberKnife SRS at Stanford University Medical Center. All patients underwent magnetic resonance imaging and visual and neuroendocrine evaluations before and at regular intervals after SRS. A multisession treatment regimen and a nonisocentric treatment plan for each patient were used with a mean marginal dose of 21.6 Gy and a mean maximal dose of 29.9 Gy. Results There were adequate clinical data to assess outcomes in 11 of 16 patients. Evaluation of patients between 13 and 71 years of age (mean 34.5 years) with a mean follow-up period of 15.4 months revealed no deterioration in visual or neuroendocrine function. Tumor shrinkage was achieved in 7 of these 11 patients, and tumor control in another 3. One patient had cystic enlargement of the residual tumor. Conclusions The authors' early experience with the application of CyberKnife SRS to residual or recurrent craniopharyngiomas has been positive; control or shrinkage of the tumor was achieved in 91% of patients, with no visual or neuroendocrine complications. Longer-term follow-up with a larger group of patients is required to fully evaluate the safety and effectiveness of this treatment modality.