Intracystic Bleomycin for Cystic Craniopharyngiomas in Children (Abridged Republication of Cochrane Systematic Review)

Liu, Wenke; Yuan, Fang; Cai, Biao; Xu, Jianguo; You, Chao; Zhang, Heng

doi:10.1227/neu.0b013e31826d5c31

Cited by 14 publications

(8 citation statements)

References 28 publications

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“…Jiang treated 19 patients, either with bleomycin, 32 P, or bleomycin followed by a single injection of 32 P (Jiang et al, 2002;Liu et al, 2012). This study did not demonstrate any statistical difference between the three groups in terms of response or side effects.…”

Section: Intracavitary Therapy: Intracavitary Chemotherapymentioning

confidence: 73%

Intracavitary Therapy

2015

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Section: Intracavitary Therapy: Intracavitary Chemotherapymentioning

confidence: 73%

Intracavitary Therapy

2015

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“…An intracystic injection of bleomycin or interferon and the placement of an Ommaya reservoir to drain the cystic fluid have both been reported as effective [10,11,12,13], but neither method has been validated in randomized controlled trials. Gamma knife surgery is believed to be less effective for cystic CP compared with solid CP [14], and also carries a risk of pathological malignant transformation after radiotherapy [15].…”

Section: Discussionmentioning

confidence: 99%

Unicystic Ameloblastomatoid Cystic Craniopharyngioma: Pathological Discussion and Clinical Significance of Cyst Formation in Adamantinomatous Craniopharyngioma

Okada

Fujitsu²,

Ichikawa³

et al. 2016

Pediatr Neurosurg

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An 8-year-old boy presented complaining principally of headache and vomiting. A single large cystic lesion extending from the suprasellar region to the ventral brainstem was identified, and total extirpation was performed via a right orbitozygomatic, transtemporal transchoroidal fissure approach. The cyst contents resembled motor oil, and no strong adhesions were identified between the tumor and the surrounding tissue except at the site of origin of the tumor, allowing easy dissection. The tumor originated at the junction of the adenohypophysis and the pituitary stalk. Although the histopathological diagnosis was adamantinomatous craniopharyngioma, the cyst walls comprising the majority of the tumor were not thin, fragile tissues formed by squamous metaplasia, but were thick and robust, bearing a close resemblance to unicystic ameloblastoma mixed with solid tissue. The existence of this type of cyst wall represents corroborating evidence that craniopharyngiomas are derived from the oral primordium. The existence of such tumors that can be totally extirpated in a single procedure while preserving hypothalamo-pituitary function may be taken as a warning not to rush at random to perform treatments that might encourage recurrence or regrowth by carrying out cyst fenestration and drug injection with the addition of stereotactic radiotherapy.

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“…[24] Cysts can also be controlled by instillation of the cyst with radioactive colloids or chemotherapeutic agents such as bleomycin and IFN. [28][29][30][31][32][33] Other techniques to deliver localized radiation to the craniopharyngioma while minimizing the damage to surrounding vital structures include stereotactic radiotherapy (SRT), stereotactic radiosurgery (SRS) and gamma knife radiosurgery. [34] Sainte-Rose et al, based on their finding that quality-of-life was most severely affected when radical surgery was attempted in children having a pre-operative MRI showing invasion of the hypothalamus by the craniopharyngioma (Type 2), recommended conservative surgery preserving the hypothalamic region followed by RT in such patients.…”

Section: Role Of Conservative Managementmentioning

confidence: 99%

Management of craniopharyngiomas: Role of conservative strategies

Pillai¹

2013

IJNS

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Craniopharyngiomas are uncommon tumors and their management remains controversial. Despite gross total resection, recurrences can occur in 15-43% during long-term follow-up of more than 10 years. Furthermore, radical surgery can be associated with complications associated with hypothalamic damage, which can lead to a poor quality-of-life. Limited surgery followed by adjuvant radiotherapy (RT) can provide excellent long-term tumor control with minimum complications and good functional outcome. RT can however, produce insidious onset of hypopituitarism and vasculopathy. Secondary malignancies are a rare complication of RT. Modern radiation techniques and intracystic radiation can reduce these complications. Intracystic radiation is highly effective for cystic craniopharyngiomas. Intracystic bleomycin (ICB) and interferon alpha (IFN) are rarely curative, but can produce long lasting control of tumor cysts and this is very useful in very young children who may not tolerate radical surgery or RT. IFN has fewer toxicity issues compared to ICB.

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Intracystic Bleomycin for Cystic Craniopharyngiomas in Children (Abridged Republication of Cochrane Systematic Review)

Abstract: Based on the currently available evidence, we are not able to give recommendations for the use of intracystic bleomycin in the treatment of cystic craniopharyngiomas in children. High-quality randomized, controlled trials are needed.

Cited by 14 publications

References 28 publications

Intracavitary Therapy

Intracavitary Therapy

Unicystic Ameloblastomatoid Cystic Craniopharyngioma: Pathological Discussion and Clinical Significance of Cyst Formation in Adamantinomatous Craniopharyngioma

Management of craniopharyngiomas: Role of conservative strategies

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