Therapeutic Role of Intracavitary Bleomycin Administration in Cystic Craniopharyngioma

Broggi, Giovanni; Giorgi, C.; Franzini, Angelo; Leocata, Filippo; Riva, Daria

doi:10.1007/978-88-470-2291-1_11

Cited by 19 publications

(23 citation statements)

References 2 publications

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“…One of the concerns with the transventricular route is that there may be toxic effects from spillage of the cyst contents into the ventricular system. 5 However, such spillage has not caused any ill effects in our experience. 16 Realtime ultrasonography or endoscopy is helpful in directing the catheter into the cyst, especially when the cyst wall is tough.…”

Section: Intracystic Bleomycinmentioning

confidence: 56%

“…Subsequently, there have been a number of single-center case series 5,14,16,22,25,27,33,35 and case reports 1,3,9,17,26,41,42 published on the use of intracystic bleomycin for craniopharyngioma, both as de novo treatment and as treatment for recurrences. In addition, the experience of intratumoral bleomycin use across multiple centers in Canada has been reviewed.…”

Section: Intracystic Bleomycinmentioning

confidence: 99%

“…19 At a mean follow-up of 2 to 7 years (the range of means for the studies), 43 to 70% of patients required no treatment in addition to bleomycin, 5,16,19,33,43 but there is no information about the durability of the bleomycin effect at 10 years or longer. In the Canadian experience, 19 which is similar to the other reported series, 94% responded to intracystic bleomycin, but the duration of response was < 1 year in 47%.…”

Section: Intracystic Bleomycinmentioning

confidence: 99%

“…In a review of the complications of intracystic bleomycin in 189 patients with brain tumors, Linnert et al 28 identified 5 patients (3%) with severe adverse effects and 6 patients (3%) with moderate adverse effects. Reported delayed complications include sensorineural hearing loss, 5,14 peritumoral edema, 19 visual loss, 33,35 hypothalamic dysfunction resulting in transient hypersomnolence, personality changes, poor memory, 17,35 cerebral ischemia, 5 hemiparesis, 22,35 progressive panhypopituitarism, 19 precocious puberty, 19 and death possibly related to a high individual and cumulative dose. 42 There have been a number of reported cases of moyamoya disease after intracystic bleomycin treatment for craniopharyngioma in patients who have also received radiotherapy, and it may be that radiotherapy sensitizes the vessels to bleomycin or vice versa.…”

Section: Intracystic Bleomycinmentioning

confidence: 99%

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Intracystic treatments for craniopharyngioma

Steinbok¹,

Hukin

2010

FOC

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Craniopharyngioma is a benign tumor histopathologically and in theory should be curable by radical resection. In practice, this tumor behaves like a chronic disease, with many issues related to the effect of the tumor itself and the various treatments on the adjacent structures, such as the pituitary stalk and gland, hypothalamus, visual apparatus, and suprasellar arteries. A multimodality approach to the management of these tumors may produce the optimal outcome, balancing disease control and quality of life. In this paper, the role of intracystic therapies is reviewed, with the major focus on intracystic bleomycin and interferon-α.

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Section: Intracystic Bleomycinmentioning

confidence: 56%

Section: Intracystic Bleomycinmentioning

confidence: 99%

Section: Intracystic Bleomycinmentioning

confidence: 99%

Section: Intracystic Bleomycinmentioning

confidence: 99%

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Intracystic treatments for craniopharyngioma

Steinbok¹,

Hukin

2010

FOC

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“…Some series indicated that the radical surgical intervention was associated with a 40% incidence of hypothalamic damage and a 19% incidence of visual impairment (15,16). These results led other surgeons to favor a conservative surgical approach combined with external radiotherapy, radiosurgery, colloidal radioisotope intracavitary irradiation, and intracavitary bleomycin injection (1)(2)(3)(4)(5)(6)(7)(17)(18)(19). Radiotherapy may be effective in preventing the recurrence of tumor when total excision is impossible, however, because craniopharyngioma is histologically a benign tumor occurring adjacent to the hypothalamus and pituitary gland, radiotherapy should be considered carefully, especially in childhood and young adults.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Postoperative Intratumoral Bleomycin Injection for Cystic Craniopharyngioma

Park

Kim

et al. 2002

J Korean Med Sci

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Total excision is a treatment of choice in preventing the relapse of craniopharyngioma, but for tumors involving an extensive area, it is often associated with an increased risk of complications. We have performed a partial or subtotal tumor removal followed by repeated injection of bleomycin into the remaining tumor through a subcutaneous reservoir as postoperative adjuvant therapy. A retrospective review of clinical, radiological, and surgical data was performed for 10 patients (5 males and 5 females; age, 3-65 yr; follow-up duration, 12-79 months) with cystic craniopharyngiomas. The measurements of lactate dehydrogenase (LDH) level at each aspiration were performed. The shrinkage and/or stabilization of tumor was initially noted in all cases. The recurrence of tumor was seen in 4 cases (40%). The decreased or increased level of LDH was interpreted as tumor shrinkage or recurrence, respectively. The transient toxic reactions were observed in 3 patients (30%). Our study demonstrates that postoperative bleo-mycin injection for cystic craniopharyngioma, although does not appear to eradicate the tumor, decreases and stabilizes the tumor size, when used as an adjuvant therapy in young patients.

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Intracystic bleomycin therapy for craniopharyngioma in children

Hukin

Steinbok

Lafay‐Cousin

et al. 2007

Cancer

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BACKGROUND.Surgical removal and radiation therapy are associated with significant risk for morbidity in the pediatric population with craniopharyngioma. Intracystic therapies have been utilized in some centers to potentially decrease morbidity associated with cystic craniopharyngioma. The aim of the study was to review the Canadian experience with intracystic bleomycin therapy (ICB).METHODS.All centers in the Canadian Pediatric Brain Tumor Consortium (CPBTC) were invited to participate in a retrospective review of this treatment. A questionnaire was sent to each center. The data were analyzed at British Columbia's Children's Hospital.RESULTS.In all, 6 of 17 centers utilized ICB and submitted data. A total of 17 of 19 patients with the intention to treat received bleomycin. Twelve were treated at the time of diagnosis, and 5 at the time of recurrence. Five patients achieved a complete response, 6 achieved a partial response, and 5 achieved a minor response to bleomycin. One patient was stable for 2.8 years. At the time of last follow‐up, 8 patients have not required further intervention. Complications included transient symptomatic peritumoral edema (2 patients), precocious puberty (1 patient) and panhypopituitarism (2 patients). The median follow‐up was 4 years (range, 0.5–10.2 years). The median progression‐free survival was 1.8 years (range, 0.3–6.1 years). One patient died of a massive infarct secondary to radiation‐induced moyamoya syndrome.CONCLUSIONS.ICB was found to be well tolerated in this group of children. ICB may be a feasible and effective therapy for certain children with craniopharyngioma. Bleomycin may delay the need for aggressive surgery or radiation therapy for several years. Prospective multiinstitutional clinical trials are required to further evaluate the feasibility, effectiveness, and dose schedules of this treatment. Cancer 2007. © 2007 American Cancer Society.

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Therapeutic Role of Intracavitary Bleomycin Administration in Cystic Craniopharyngioma

Cited by 19 publications

References 2 publications

Intracystic treatments for craniopharyngioma

Intracystic treatments for craniopharyngioma

Outcome of Postoperative Intratumoral Bleomycin Injection for Cystic Craniopharyngioma

Intracystic bleomycin therapy for craniopharyngioma in children

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