Reirradiation for recurrent craniopharyngioma

Abstract

Purpose Reirradiation is rarely administered to patients with recurrent craniopharyngioma owing to concerns regarding visual and endocrine side effects. The purpose of this case series was to evaluate our institutional experience of patients with craniopharyngioma treated with 2 courses of fractionated radiation therapy. Methods and Materials A retrospective study was performed of all patients with craniopharyngioma treated with 2 courses of fractionated radiation therapy at a single institution. Electronic medical records and radiation therapy records were reviewed. Results We identified 4 eligible patients with recurrent craniopharyngioma. With a median follow-up of 33 months after reirradiation, 3 patients attained disease control; 1 patient developed progressive disease, 27 months after reirradiation. In 3 evaluable patients, vision remained stable or improved after reirradiation; one patient had no light perception before reirradiation. None of the patients experienced additional endocrine toxicities after reirradiation, apart from one patient who had low serum thyroid stimulating hormone before reirradiation and later developed hypothyroidism after treatment. Conclusions Reirradiation may represent a safe and effective therapeutic option for selected patients with recurrent, refractory craniopharyngioma and without other salvage treatment options. Larger studies with longer-term follow up are warranted to better understand outcomes in these patients.

A 55-Year-Old Woman Presenting with a Second Diagnosis of Craniopharyngioma Following Diagnosis and Successful Treatment of Craniopharyngioma as a 5-Year-Old Child

“…Only when the patient exhibits indicators such as compressive symptoms or a midline shift should surgery be done [11,25,26]. Reirradiation is an alternative to surgery for selected patients with recurrent, refractory craniopharyngiomas, and it appears that stereotactic radiotherapy can be successful for controlling recurrent tumors after surgery, especially if the tumor is too close to the optic chiasm [4,[27][28][29][30][31]. Other alternatives include radiosurgery, intracystic radiation, bleomycin administration, and salvage surgery for solid lesions that pose a serious threat to life [32,33].…”