Preliminary Results of Intracavitary Irradiation of Cystic Craniopharyngiomas by Means of Stereotactically Applied Yttrium-90

Sturm, Volker; Rommel, Th.; Strauss, L.; Georgi, P.; Scheer, K. E.; Steude, U.; Stock, G.; Penzholz, H.; Backlund, Erik‐Olof

doi:10.1007/978-3-642-67943-8_64

Cited by 7 publications

(3 citation statements)

References 4 publications

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“…Backlund ~ reported a single case of subarachnoid hemorrhage and subsequent death resulting from inadvertent puncture of the anterior cerebral artery. Sturm, et al, 24 described a frontal hematoma in one of their patients. Julow, et al, 9 reported a patient who developed fatal meningitis after cyst puncture.…”

Section: Discussionmentioning

confidence: 97%

Stereotaxic intracavitary irradiation for cystic craniopharyngiomas

Pollack

Lunsford

Slamovits

et al. 1988

Journal of Neurosurgery

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Stereotaxic intracavitary irradiation with instillation of phosphorus-32 (32P) colloidal chromic phosphate was performed in nine patients with cystic craniopharyngiomas. Serial neurological, ophthalmological, neuroendocrinological, and radiological examinations were performed before and after treatment. Dosimetry was determined based on a computerized tomography (CT) estimation of tumor volume, and was calculated to provide a tumoricidal dose (200 to 300 Gy) to the cyst wall. The follow-up period ranged from 14 to 45 months (mean 27 months). After treatment, all nine patients showed improvement of symptoms and radiological evidence of cyst regression. Because of an expanding solid component producing recurrent symptoms, one patient required a craniotomy 14 months after isotope instillation. Three of five patients with impaired visual acuity before surgery had significant improvement in acuity after treatment. Preoperative visual field defects in eight patients improved in four after 32P therapy. Of seven patients with preoperative endocrine abnormalities, one individual showed almost complete normalization and another had improvement in endocrine function. Patients who exhibited residual neuroendocrine function before isotope instillation developed no significant deterioration in endocrine status during the follow-up period. The findings suggest that stereotaxic intracavitary irradiation is a safe and effective treatment which should be considered as the initial surgery for cystic craniopharyngiomas.

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Section: Discussionmentioning

confidence: 97%

Stereotaxic intracavitary irradiation for cystic craniopharyngiomas

Pollack

Lunsford

Slamovits

et al. 1988

Journal of Neurosurgery

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“…The shrinkage of the cyst following 90 Y-STAIR or other beta-emitting radioisotopes begins after several months and becomes stable after 6 months to 1 year. [3,13,34,40,42,44,45] From our repeated CT measurements we concluded that the time course of shrinkage of craniopharyngioma cysts following 90 Y-STAIR might be expressed mathematically by the formula 0.73 X e -0.62 X T + 0.27, where "e" is the basic number of natural logarithm and "T" is the time expressed in months. Figure 3 shows the duration of VR following 90 Y-STAIR based on CT measurements (continuous curve) and estimated by our formula (dotted line).…”

Section: Discussionmentioning

confidence: 87%

Treatment of cystic craniopharyngiomas with yttrium-90 colloid solution.

Degnan

1997

FOC

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The authors analyzed long-term follow-up data to assess the value of intracavitary irradiation with stereotactically implanted beta-emitting radioisotope 90Y-silicate colloid for the treatment of craniopharyngiomas. Fifty-seven craniopharyngiomas in 42 patients were selected for retrospective analysis. The yttrium-90 was implanted intracavitally, using computerized tomography-guided and three-dimensional stereotactic treatment planning. The cumulative dose aimed at the inner surface of the cyst wall was 300 Gy. An average of 75% shrinkage of the initial cyst volume was observed. In 18 cases the reduction was more than 91%, and the cyst disappeared totally in 11 cases. A 50% decrease in cyst volume was usually apparent between the 2nd and 4th months. A 70% decrease in cyst volume was seen by the 5th and 6th months and an 80% reduction by the 7th and 8th months. Cysts that were unchanged remained so throughout the observation period. The time course of volume reduction could be expressed mathematically by the formula of 0.73 X e-0.62 X T + 0.27, where “e” is the basic number of natural logarithm and “T” is the time expressed in months. Mean survival duration after intracavitary irradiation was 9.4 years. The shrinkage of the cyst was a consequence of fibrosis of the wall, as seen on histopathological examination. The neuroophthalmological prognosis was favorable only when the optic disc was normal or nearly normal at the time of the treatment. In the presence of preexisting optic atrophy, visual deterioration proved to be irreversible. The long-term results support the view that intracavitary90Y-irradiation is a noninvasive and very effective method of treatment for craniopharyngioma cysts. Because of the 1.1 mm half-life decay of beta irradiation, it cannot influence the solid part of the tumor; therefore, the best result can be expected in solitary cysts.

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“…The possible complications of this technique can be related to the stereotactic procedure itself (what is uncommon) or to the radioisotope injection, and they include intracerebral hematoma after cyst puncture, 21 meningitis, 18 19 and necrotic hemorrhage. All of these complications have been observed in the treatement of craniopharyngiomas using 90 Y.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Intracavitary Irradiation for Cystic Craniopharyngiomas with Rhenium-186

Fagundes,

Souza,

Touzet

et al. 2023

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Objective The intracavitary irradiation of cystic tumors has been used as a therapeutic alternative modality in the management of cystic craniopharyngiomas. In the present study, we review our experience, considering the technical issues, outcomes, and complications associated with the use of stereotactic intracavitary irradiation (SICI) with colloidal rhenium-186 (186Re) for cystic craniopharyngioma. Material and Methods The records of 33 patients with cystic craniopharyngiomas treated by SICI with colloidal 186Re were retrospectively reviewed. The median radiation dose to the cyst wall was of 408 Gy (range: 175 Gy to 500 Gy). All tumors were composed of a large cyst cavity, and 9 (27.3%) also had a solid component. The mean follow-up period was of 3.7 years. Results After SICI, 31 (93.9%) patients showed radiological evidence of cyst regression, and, in 2 (6.1%), no response was observed. An improvement in the visual deficits was observed in 8 cases (24.2%), and an improvement in endocrinogical disturbances, in 2 cases (6.1%). We observed complications in 3 patients (9.1%): diabetes insupidus in 1 case (3%), aggravation of visual acuity in 1 case (3%), and severe headache after infusion of the colloid in 1 case (3%); and 1 patient (3%) died after meningitis. Conclusion Stereotactic intracavitary irradiation with colloidal 186Re is a safe procedure, with satisfactory results in the present series, and should be considered, in the management of cystic craniopharyngiomas, the first-intention therapy or as an adjuvant to other therapeutical modalities, with acceptable morbidity and mortality rates.

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Preliminary Results of Intracavitary Irradiation of Cystic Craniopharyngiomas by Means of Stereotactically Applied Yttrium-90

Cited by 7 publications

References 4 publications

Stereotaxic intracavitary irradiation for cystic craniopharyngiomas

Stereotaxic intracavitary irradiation for cystic craniopharyngiomas

Treatment of cystic craniopharyngiomas with yttrium-90 colloid solution.

Stereotactic Intracavitary Irradiation for Cystic Craniopharyngiomas with Rhenium-186

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