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Neuro-Oncology 2001 3(3):159-166; doi:10.1093/neuonc/3.3.159
© 2001 by Society
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© 2001 by the Society forNeuro-Oncology

Stereotactic radiosurgery of residual or recurrent craniopharyngioma,after surgery, with or without radiation therapy

Shang-Ming Chiou, L. Dade Lunsford1, Ajay Niranjan, Douglas Kondziolka and John C. Flickinger

Department of Neurological Surgery and Radiation Oncology, Center forImage-Guided Neurosurgery, University of Pittsburgh Medical Center,Pittsburgh, PA 15213

1 Address correspondence and reprint requests to L. Dade Lunsford, Professor andChairman, Department of Neurological Surgery, Professor of Radiology andRadiation Oncology, The University of Pittsburgh, University of PittsburghMedical Center-Presbyterian, Suite B-400, 200 Lothrop St., Pittsburgh, PA15213-2582.


  Abstract

This study evaluated the role of stereotactic radiosurgery in themultimodality management of craniopharyngioma patients whose prior therapiesfailed. Ten consecutive patients (3 males and 7 females) had radiosurgery forcraniopharyngioma during a 10-year interval. Their ages ranged from 9 to 64years (median, 14.5 years). The median interval between diagnosis andradiosurgery was 46.5 months. In total, 12 stereotactic radiosurgicalprocedures were performed to control the solid component of the tumor (2intrasellar and 10 suprasellar tumors). The median tumor volume was 1.35cm3. One to 9 isocenters with different beam diameters were used;the median marginal dose was 16.4 Gy; and the dose to the optic apparatus waslimited to less than 8 Gy. Clinical and imaging follow-up data were obtainedat a median of 63 months (range, 13-150 months) from radiosurgery. Overall, 7of 12 tumors became smaller or vanished within a median of 8.5 months. Priorvisual defects objectively improved in 6 patients. One patient with priorvisual defect deteriorated further and lost vision 9 months afterradiosurgery. Multimodality therapy is often necessary for patients withrefractory solid and cystic craniopharyngiomas. Stereotactic radiosurgery is areasonable option in select patients with small recurrent or residualcraniopharyngioma.

Received September 7, 2000; Accepted January 16, 2001


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