:
To investigate outcome and toxicity after fractionated
stereotactic radiation therapy (FSRT) in patients with
craniopharyngiomas.
:
Twenty-six patients with craniopharyngiomas were treated
with FSRT between May 1989 and February 2001. Median age was
33.5 years (range: 5–57 years). Nine patients received FSRT
after surgery as primary treatment, and 17 patients were
irradiated for recurrent tumor or progressive growth after
initial surgery.
Median target dose was 52.2 Gy (range: 50.0–57.6 Gy)
with conventional fractionation. Follow-up included MRI and
neurologic, ophthalmologic, and endocrinologic examinations.
:
The median follow-up was 43 months (range: 7–143 months).
The actuarial local
control rate and actuarial overall survival rates were 100%
and 100%, respectively, at 5 years and 100% and 83%,
respectively, at 10 years. Four patients showed
complete response, 14 patients showed partial response, and
8 patients remained stable. In 5 patients, vision improved
after radiation therapy. Acute toxicity was mild. One
patient required cyst drainage 3 months after radiotherapy.
Late toxicity after radiotherapy included impairment of
hormone function in 3 out of 18 patients at risk. We did not
observe any vision impairment, radionecrosis, or secondary
malignancies.
:
FSRT is effective and safe in the treatment of cystic
craniopharyngiomas. Toxicity is extremely low using this
conformal technique.