The Role of Teleradiotherapy in the Management of Craniopharygioma

Abstract

Purpose: The purpose of this study was to evaluate the effectiveness of teleradiotherapy in the treatment of primary and recurrent craniopharygioma patients treated at the Veterans General Hospital-Taipei. Materials and Methods: Between 1980 and 1991, 41 patients received primary management of craniopharyngioma in the VGH-Taipei. Gross total removal of tumor was performed in 25 patients (Group Ⅰ). Six patients had subtotal removal of tumor (Group Ⅱ), 6 patients had subtotal removal with postoperative radiotherapy (Group Ⅲ). Four patients had teleradiotherapy alone Group Ⅳ). Sixteen patients out of the 19 patients from Group Ⅰ and Group Ⅱ with recurrent tumors received salvage radiotherapy. Median tumor dose prescribed at the 90% isodose volume were 52, 60 and 53 Gy for Group Ⅲ, Ⅳ and recurrent tumors, respectively. The fraction size was 2.0 Gy. Either 10 MV or cobalt 60 was used. Result: Of five-year progression-free survival was 41.3% for the whole series, and 25.8%, 13.3%, 100%, 75% for Groups Ⅰ, Ⅱ, Ⅲ and Ⅳ, respectively (p-0.0231). The actuarial five-year local control rate after salvage radiotherapy for recurrent disease was 81.3%. The median tumor control duration were 11, 8, 50, 82 months. Rates of diabetes insipidus were 56%, 50%, 33%, 0% for Group Ⅰ, Ⅱ, Ⅲ and Ⅳ, respectively. Conclusion: This study shows that definitive, adjuvant and salvage radiotherapy all lead to significant improvement in local control of craniopharyngioma with few complications. Postoperative radiotherapy is also highly recommended for patients treated with subtotal resection of tumor.