Stereotactic radiosurgery for craniopharyngiomas.
Craniopharyngioma
Gamma Knife
Radiosurgery
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
05
08
2021
accepted:
25
08
2021
pubmed:
15
9
2021
medline:
25
11
2021
entrez:
14
9
2021
Statut:
ppublish
Résumé
The management of craniopharyngiomas is challenging, usually requiring multidisciplinary care. We evaluated the long-term clinical and radiologic outcomes of Gamma Knife radiosurgery (GKRS) for craniopharyngiomas. This retrospective study involved patients managed with GKRS for a craniopharyngioma during the period of 1989 to 2019. Patient clinical and radiologic data, tumor characteristics, and procedural details were analyzed. Thirty-eight consecutive patients (24 males; mean patient age at GKRS = 30.82 years [SD ± 20.45 years]) were treated with GKRS for craniopharyngioma. Overall survival rates at 5 and 10 years were 84.1% and 80.1%, respectively. Progression-free survival at 5 years was 48.1%, and, at 10 years, it was 29.8%. Risk factors for post-GKRS clinical deterioration were increasing number of isocenters used (p = 0.04 (HR1.32, CI 1-1.73)), increasing margin dose [p = 0.02 (HR1.52, CI 1.31-1.84)], and maximum dose > 35 Gy [p = 0.002 (HR1.35, CI 1.11-1.63)]. Stereotactic radiosurgery (SRS) appears a safe and effective management option in selected craniopharyngioma patients. Increasing margin dose and maximum dose > 35 Gy are associated with an increased risk for post-SRS neurologic deficit. Further, well-designed studies are necessary to determine the optimal timing and SRS parameters and to identify which patients with craniopharyngioma will benefit the most from SRS.
Sections du résumé
BACKGROUND
The management of craniopharyngiomas is challenging, usually requiring multidisciplinary care. We evaluated the long-term clinical and radiologic outcomes of Gamma Knife radiosurgery (GKRS) for craniopharyngiomas.
METHODS
This retrospective study involved patients managed with GKRS for a craniopharyngioma during the period of 1989 to 2019. Patient clinical and radiologic data, tumor characteristics, and procedural details were analyzed.
RESULTS
Thirty-eight consecutive patients (24 males; mean patient age at GKRS = 30.82 years [SD ± 20.45 years]) were treated with GKRS for craniopharyngioma. Overall survival rates at 5 and 10 years were 84.1% and 80.1%, respectively. Progression-free survival at 5 years was 48.1%, and, at 10 years, it was 29.8%. Risk factors for post-GKRS clinical deterioration were increasing number of isocenters used (p = 0.04 (HR1.32, CI 1-1.73)), increasing margin dose [p = 0.02 (HR1.52, CI 1.31-1.84)], and maximum dose > 35 Gy [p = 0.002 (HR1.35, CI 1.11-1.63)].
CONCLUSION
Stereotactic radiosurgery (SRS) appears a safe and effective management option in selected craniopharyngioma patients. Increasing margin dose and maximum dose > 35 Gy are associated with an increased risk for post-SRS neurologic deficit. Further, well-designed studies are necessary to determine the optimal timing and SRS parameters and to identify which patients with craniopharyngioma will benefit the most from SRS.
Identifiants
pubmed: 34518903
doi: 10.1007/s00701-021-04990-1
pii: 10.1007/s00701-021-04990-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3201-3207Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
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