Skip to main content
SpringerLink
Log in

Intracystic Administration of Interferon-Alpha for Reduction of Cystic Tumour Burden

  • Chapter
  • First Online:
Basic Research and Clinical Aspects of Adamantinomatous Craniopharyngioma

Abstract

Despite technical advances in the neurosurgical and radiotherapeutic foundations of craniopharyngioma treatment, clinical management remains controversial with persisting high morbidity rates for those affected. As such, there continues to be a scope for therapeutic improvements and innovation in the field. The cystic composition of adamantinomatous craniopharyngiomas (ACPs) makes them an ideal candidate to evaluate one such development; the instillation of intracystic agents. This mode of drug delivery aims to obtain durable cyst shrinkage with minimum consequent morbidity and toxicity for patients. In this chapter we will highlight common agents used to date, paying particular attention to the drug currently gaining interest, interferon-alpha.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Holsken A et al (2016) Adamantinomatous and papillary craniopharyngiomas are characterized by distinct epigenomic as well as mutational and transcriptomic profiles. Acta Neuropathol Commun 4(1):20

    Article  PubMed  PubMed Central  Google Scholar 

  2. Mallucci C et al (2012) Management of craniopharyngioma: the Liverpool experience following the introduction of the CCLG guidelines. Introducing a new risk assessment grading system. Childs Nerv Syst 28(8):1181–1192

    Article  PubMed  Google Scholar 

  3. Steinbok P, Hukin J (2010) Intracystic treatments for craniopharyngioma. Neurosurg Focus 28(4):E13

    Article  PubMed  Google Scholar 

  4. Duff J et al (2000) Long-term outcomes for surgically resected craniopharyngiomas. Neurosurgery 46(2):291–302 discussion 302-5

    Article  CAS  PubMed  Google Scholar 

  5. Fahlbusch R et al (1999) Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 90(2):237–250

    Article  CAS  PubMed  Google Scholar 

  6. Villani RM et al (1997) Long-term results of treatment for craniopharyngioma in children. Childs Nerv Syst 13(7):397–405

    Article  CAS  PubMed  Google Scholar 

  7. Clark AJ et al (2012) Treatment-related morbidity and the management of pediatric craniopharyngioma: a systematic review. J Neurosurg Pediatr 10(4):293–301

    Article  PubMed  Google Scholar 

  8. Muller HL (2010) Childhood craniopharyngioma: current controversies on management in diagnostics, treatment and follow-up. Expert Rev Neurother 10(4):515–524

    Article  PubMed  Google Scholar 

  9. Yang I et al (2010) Craniopharyngioma: a comparison of tumor control with various treatment strategies. Neurosurg Focus 28(4):E5

    Article  PubMed  Google Scholar 

  10. Kalapurakal JA et al (2003) Clinical outcome in children with craniopharyngioma treated with primary surgery and radiotherapy deferred until relapse. Med Pediatr Oncol 40(4):214–218

    Article  PubMed  Google Scholar 

  11. Srinivasan S et al (2004) Features of the metabolic syndrome after childhood craniopharyngioma. J Clin Endocrinol Metab 89(1):81–86

    Article  CAS  PubMed  Google Scholar 

  12. Merchant TE et al (2006) Phase II trial of conformal radiation therapy for pediatric patients with craniopharyngioma and correlation of surgical factors and radiation dosimetry with change in cognitive function. J Neurosurg 104(2 Suppl):94–102

    PubMed  Google Scholar 

  13. Hargrave DR (2006) Does chemotherapy have a role in the management of craniopharyngioma? J Pediatr Endocrinol Metab 19(Suppl 1):407–412

    PubMed  Google Scholar 

  14. Bartels U et al (2012) Intracystic therapies for cystic craniopharyngioma in childhood. Front Endocrinol (Lausanne) 3:39

    Google Scholar 

  15. Moussa AH, Kerasha AA, Mahmoud ME (2013) Surprising outcome of ommaya reservoir in treating cystic craniopharyngioma: a retrospective study. Br J Neurosurg 27(3):370–373

    Article  CAS  PubMed  Google Scholar 

  16. Spaziante R et al (1989) Management of primary or recurring grossly cystic craniopharyngiomas by means of draining systems. Topic review and 6 case reports. Acta Neurochir (Wien) 97(3–4):95–106

    Article  CAS  Google Scholar 

  17. Zanon N, Cavalheiro S, da Silva MC (2008) Does the choice of surgical approach to insert an intratumoral catheter influence the results of intratumoral cystic treatment? Surg Neurol 70(1):66–69 discussion 69

    Article  PubMed  Google Scholar 

  18. Pettorini BL et al (2009) Endoscopic transventricular positioning of intracystic catheter for treatment of craniopharyngioma. Technical note. J Neurosurg Pediatr 4(3):245–248

    Article  PubMed  Google Scholar 

  19. Joki T et al (2002) Neuroendoscopic placement of Ommaya reservoir into a cystic craniopharyngioma. Childs Nerv Syst 18(11):629–633

    Article  PubMed  Google Scholar 

  20. Hellwig D, Bauer BL, List-Hellwig E (1995) Stereotactic endoscopic interventions in cystic brain lesions. Acta Neurochir Suppl 64:59–63

    Article  CAS  PubMed  Google Scholar 

  21. Floyd JR et al (2009) Endoscopic, image-guided, transnasal instillation of (32)P for recurrent infrachiasmatic cystic craniopharyngioma. Minim Invasive Neurosurg 52(3):137–140

    Article  CAS  PubMed  Google Scholar 

  22. Sanford RA (1994) Craniopharyngioma: results of survey of the American Society of Pediatric Neurosurgery. Pediatr Neurosurg 21(Suppl 1):39–43

    PubMed  Google Scholar 

  23. Backlund EO (1973) Studies on craniopharyngiomas. IV. Stereotaxic treatment with radiosurgery. Acta Chir Scand 139(4):344–351

    CAS  PubMed  Google Scholar 

  24. Musolino A et al (1985) Stereotaxic treatment of expanding cysts in craniopharyngiomas by endocavitary beta-irradiation (Re-186; Au-198; Y-90). Neurochirurgie 31(3):169–178

    CAS  PubMed  Google Scholar 

  25. Voges J et al (1997) Cystic craniopharyngioma: long-term results after intracavitary irradiation with stereotactically applied colloidal beta-emitting radioactive sources. Neurosurgery 40(2):263–269 discussion 269–70

    Article  CAS  PubMed  Google Scholar 

  26. Hasegawa T et al (2004) Management of cystic craniopharyngiomas with phosphorus-32 intracavitary irradiation. Neurosurgery 54(4):813–820 discussion 820–2

    Article  PubMed  Google Scholar 

  27. Kickingereder P et al (2012) Intracavitary brachytherapy using stereotactically applied phosphorus-32 colloid for treatment of cystic craniopharyngiomas in 53 patients. J Neurooncol 109(2):365–374

    Article  CAS  PubMed  Google Scholar 

  28. Yu X et al (2015) Interstitial radiotherapy using phosphorus-32 for giant posterior fossa cystic craniopharyngiomas. J Neurosurg Pediatr 15(5):510–518

    Article  PubMed  Google Scholar 

  29. Julow JV (2013) Intracystic irradiation for craniopharyngiomas. Pituitary 16(1):34–45

    Article  PubMed  Google Scholar 

  30. Derrey S et al (2008) Management of cystic craniopharyngiomas with stereotactic endocavitary irradiation using colloidal 186Re: a retrospective study of 48 consecutive patients. Neurosurgery 63(6):1045–1052 discussion 1052–3

    Article  PubMed  Google Scholar 

  31. Pollock BE et al (1995) Phosphorus-32 intracavitary irradiation of cystic craniopharyngiomas: current technique and long-term results. Int J Radiat Oncol Biol Phys 33(2):437–446

    Article  CAS  PubMed  Google Scholar 

  32. Blackburn TP, Doughty D, Plowman PN (1999) Stereotactic intracavitary therapy of recurrent cystic craniopharyngioma by instillation of 90yttrium. Br J Neurosurg 13(4):359–365

    Article  CAS  PubMed  Google Scholar 

  33. Ansari SF et al (2016) Efficacy of phosphorus-32 brachytherapy without external-beam radiation for long-term tumor control in patients with craniopharyngioma. J Neurosurg Pediatr 17(4):439–445

    Google Scholar 

  34. Albright AL et al (2005) Individualized treatment of pediatric craniopharyngiomas. Childs Nerv Syst 21(8–9):649–654

    Article  PubMed  Google Scholar 

  35. Barriger RB et al (2011) Phosphorus-32 therapy for cystic craniopharyngiomas. Radiother Oncol 98(2):207–212

    Article  CAS  PubMed  Google Scholar 

  36. Kubo O et al (1974) Intracystic therapy of bleomycin for craniopharyngioma--effect of bleomycin for cultured craniopharyngioma cells and intracystic concentration of bleomycin (author’s transl). No Shinkei Geka 2(10):683–688

    CAS  PubMed  Google Scholar 

  37. Cavalheiro S et al (1996) Use of bleomycin in intratumoral chemotherapy for cystic craniopharyngioma. Case report. J Neurosurg 84(1):124–126

    Article  CAS  PubMed  Google Scholar 

  38. Savas A et al (1999) Intracavitary chemotherapy of polycystic craniopharyngioma with bleomycin. Acta Neurochir (Wien) 141(5):547–548 discussion 549

    Article  CAS  Google Scholar 

  39. Alen JF et al (2002) Intratumoural bleomycin as a treatment for recurrent cystic craniopharyngioma. Case report and review of the literature. Neurocirugia (Astur) 13(6):479–485 discussion 485

    Article  CAS  Google Scholar 

  40. Hader WJ et al (2000) Intratumoral therapy with bleomycin for cystic craniopharyngiomas in children. Pediatr Neurosurg 33(4):211–218

    Article  CAS  PubMed  Google Scholar 

  41. Hsu TR, Chang KP, Wong TT (2009) Intracystic bleomycin therapy for craniopharyngioma in children. Neuro-oncology 11:902

    Google Scholar 

  42. Hukin J et al (2007) Intracystic bleomycin therapy for craniopharyngioma in children: the Canadian experience. Cancer 109(10):2124–2131

    Article  CAS  PubMed  Google Scholar 

  43. Mottolese C et al (2005) Craniopharyngiomas: our experience in Lyon. Childs Nerv Syst 21(8–9):790–798

    Article  CAS  PubMed  Google Scholar 

  44. Park DH et al (2002) Outcome of postoperative intratumoral bleomycin injection for cystic craniopharyngioma. J Korean Med Sci 17(2):254–259

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Takahashi H, Yamaguchi F, Teramoto A (2005) Long-term outcome and reconsideration of intracystic chemotherapy with bleomycin for craniopharyngioma in children. Childs Nerv Syst 21(8–9):701–704

    Article  PubMed  Google Scholar 

  46. Kim SD et al (2007) Radiological findings following postsurgical intratumoral bleomycin injection for cystic craniopharyngioma. Clin Neurol Neurosurg 109(3):236–241

    Article  PubMed  Google Scholar 

  47. Yang SH, Kim IS, Hong JT, Sung JH, Son BC, Lee SW (2009) Intratumoral bleomycin injection as a primary therapy for cystic craniopharyngioma. Neuro-oncology 11:903

    Google Scholar 

  48. Hernandez J, Morel C, Gonzalez A, Garcia S, Hernandez M, Zarate A (2002) Use of bleomycin through a local reservoir in patients with cystic craniopharyngiomas. [Spanish] Uso de la bleomicina mediante uso reservorio local en pacientes con craneofaringiomas quisticos. Medicina Interna de Mexico 18:273–277

    Google Scholar 

  49. Franzini A, Leocata F, Pintucci M, Broggi G (2001) Cystic craniopharyngioma: stereotactic intracavitary Bleomycin administration. [Italian] La somministrazione di Bleomicina intracavitaria nel trattamento chirurgico del craniofaringioma cistico. Revista Medica 7:41–45

    Google Scholar 

  50. Takahashi H, Nakazawa S, Shimura T (1985) Evaluation of postoperative intratumoral injection of bleomycin for craniopharyngioma in children. J Neurosurg 62(1):120–127

    Article  CAS  PubMed  Google Scholar 

  51. Hukin J et al (2005) Childhood craniopharyngioma: Vancouver experience. Childs Nerv Syst 21(8–9):758–765

    Article  PubMed  Google Scholar 

  52. Mottolese C et al (2001) Intracystic chemotherapy with bleomycin in the treatment of craniopharyngiomas. Childs Nerv Syst 17(12):724–730

    Article  CAS  PubMed  Google Scholar 

  53. Jiang R, Liu Z, Zhu C (2002) Preliminary exploration of the clinical effect of bleomycin on craniopharyngiomas. Stereotact Funct Neurosurg 78(2):84–94

    Article  PubMed  Google Scholar 

  54. Belen D et al (2007) Delayed neurotoxic complication of intracavitary bleomycin therapy for craniopharyngioma in a child who had previously undergone radiosurgery. Case report. J Neurosurg 106(5 Suppl):391–393

    PubMed  Google Scholar 

  55. Lafay-Cousin L et al (2007) Neuroradiological findings of bleomycin leakage in cystic craniopharyngioma. Report of three cases. J Neurosurg 107(4 Suppl):318–323

    Article  PubMed  Google Scholar 

  56. Savas A et al (2000) Fatal toxic effect of bleomycin on brain tissue after intracystic chemotherapy for a craniopharyngioma: case report. Neurosurgery 46(1):213–216 discussion 216–7

    Article  CAS  PubMed  Google Scholar 

  57. Zheng J et al (2014) Intracystic bleomycin for cystic craniopharyngiomas in children. Cochrane Database Syst Rev 9:CD008890

    Google Scholar 

  58. Fang Y et al (2012) Intracystic bleomycin for cystic craniopharyngiomas in children. Cochrane Database Syst Rev 4:CD008890

    Google Scholar 

  59. May JA et al (2006) Craniopharyngioma in childhood. Adv Pediatr 53:183–209

    Article  PubMed  Google Scholar 

  60. Pettorini BL et al (2010) The role of inflammation in the genesis of the cystic component of craniopharyngiomas. Childs Nerv Syst 26(12):1779–1784

    Article  PubMed  Google Scholar 

  61. Ierardi DF et al (2007) Apoptosis in alpha interferon (IFN-alpha) intratumoral chemotherapy for cystic craniopharyngiomas. Childs Nerv Syst 23(9):1041–1046

    Article  CAS  PubMed  Google Scholar 

  62. Hirano A, Ghatek NR, Zimmerman HM (1973) Fenestrated blood vessels in craniopharyngioma. Acta Neuropathol 26(2):171–177

    Article  CAS  PubMed  Google Scholar 

  63. Arefyeva IA et al (2002) Analysis of fluid in craniopharyngioma-related cysts in children: proteins, lactate and pH. Acta Neurochir (Wien) 144(6):551–554 discussion 554

    Article  CAS  Google Scholar 

  64. Petito CK (1996) Craniopharyngioma: prognostic importance of histologic features. AJNR Am J Neuroradiol 17(8):1441–1442

    CAS  PubMed  Google Scholar 

  65. Szeifert GT et al (1991) Secretory component of cystic craniopharyngiomas: a mucino-histochemical and electron-microscopic study. Surg Neurol 36(4):286–293

    Article  CAS  PubMed  Google Scholar 

  66. Vaquero J et al (1999) Expression of vascular permeability factor in craniopharyngioma. J Neurosurg 91(5):831–834

    Article  CAS  PubMed  Google Scholar 

  67. Stevens A, Kloter I, Roggendorf W (1988) Inflammatory infiltrates and natural killer cell presence in human brain tumors. Cancer 61(4):738–743

    Article  CAS  PubMed  Google Scholar 

  68. Le Page C et al (2000) Interferon activation and innate immunity. Rev Immunogenet 2(3):374–386

    CAS  PubMed  Google Scholar 

  69. Ferrantini M, Capone I, Belardelli F (2007) Interferon-alpha and cancer: mechanisms of action and new perspectives of clinical use. Biochimie 89(6–7):884–893

    Article  CAS  PubMed  Google Scholar 

  70. Stark GR et al (1998) How cells respond to interferons. Annu Rev Biochem 67:227–264

    Article  CAS  PubMed  Google Scholar 

  71. Platanias LC (2005) Mechanisms of type-I- and type-II-interferon-mediated signalling. Nat Rev Immunol 5(5):375–386

    Article  CAS  PubMed  Google Scholar 

  72. Ahmed S, Rai KR (2003) Interferon in the treatment of hairy-cell leukemia. Best Pract Res Clin Haematol 16(1):69–81

    Article  CAS  PubMed  Google Scholar 

  73. Strander H (1986) Interferon treatment of human neoplasia. Adv Cancer Res 46:1–265

    Article  CAS  PubMed  Google Scholar 

  74. Goldstein D, Laszlo J (1988) The role of interferon in cancer therapy: a current perspective. CA Cancer J Clin 38(5):258–277

    Article  CAS  PubMed  Google Scholar 

  75. Kirkwood JM et al (2001) High-dose interferon alfa-2b significantly prolongs relapse-free and overall survival compared with the GM2-KLH/QS-21 vaccine in patients with resected stage IIB-III melanoma: results of intergroup trial E1694/S9512/C509801. J Clin Oncol 19(9):2370–2380

    Article  CAS  PubMed  Google Scholar 

  76. Salles G et al (2008) Rituximab combined with chemotherapy and interferon in follicular lymphoma patients: results of the GELA-GOELAMS FL2000 study. Blood 112(13):4824–4831

    Article  CAS  PubMed  Google Scholar 

  77. Edwards L et al (1992) Treatment of cutaneous squamous cell carcinomas by intralesional interferon alfa-2b therapy. Arch Dermatol 128(11):1486–1489

    Article  CAS  PubMed  Google Scholar 

  78. Shin DM et al (2001) Combined interferon-alfa, 13-cis-retinoic acid, and alpha-tocopherol in locally advanced head and neck squamous cell carcinoma: novel bioadjuvant phase II trial. J Clin Oncol 19(12):3010–3017

    Article  CAS  PubMed  Google Scholar 

  79. Kim KH et al (2004) Intralesional interferon alpha-2b in the treatment of basal cell carcinoma and squamous cell carcinoma: revisited. Dermatol Surg 30(1):116–120

    PubMed  Google Scholar 

  80. Jakacki RI et al (2000) Phase II evaluation of interferon-alpha-2a for progressive or recurrent craniopharyngiomas. J Neurosurg 92(2):255–260

    Article  CAS  PubMed  Google Scholar 

  81. Yeung JT et al (2012) Pegylated interferon-alpha-2b for children with recurrent craniopharyngioma. J Neurosurg Pediatr 10(6):498–503

    Article  PubMed  Google Scholar 

  82. Gascon GG (2003) Randomized treatment study of inosiplex versus combined inosiplex and intraventricular interferon-alpha in subacute sclerosing panencephalitis (SSPE): international multicenter study. J Child Neurol 18(12):819–827

    Article  PubMed  Google Scholar 

  83. Chamberlain MC (2002) A phase II trial of intra-cerebrospinal fluid alpha interferon in the treatment of neoplastic meningitis. Cancer 94(10):2675–2680

    Article  CAS  PubMed  Google Scholar 

  84. Bailey S, Parkes J (2015) Intracystic interferon therapy in childhood craniopharyngioma: who, when and how? Clin Endocrinol (Oxf) 82(1):29–34

    Article  CAS  Google Scholar 

  85. Cavalheiro S et al (2005) Use of interferon alpha in intratumoral chemotherapy for cystic craniopharyngioma. Childs Nerv Syst 21(8–9):719–724

    Article  CAS  PubMed  Google Scholar 

  86. Cavalheiro S et al (2010) Craniopharyngiomas: intratumoral chemotherapy with interferon-alpha: a multicenter preliminary study with 60 cases. Neurosurg Focus 28(4):E12

    Article  PubMed  Google Scholar 

  87. Sharma J et al (2015) Intracystic interferon-alpha treatment leads to neurotoxicity in craniopharyngioma: case report. J Neurosurg Pediatr 16(3):301–304

    Article  PubMed  Google Scholar 

  88. Tiedemann LM et al (2016) Visual field loss in a case of recurrent cystic craniopharyngioma during concomitant treatment with pegylated interferon alpha-2b. J Pediatr Hematol Oncol 38(1):e26–e28

    Article  PubMed  Google Scholar 

  89. Mohammed KEA, Mike KRA, Parkes J (2013) Unexpected brain atrophy following administrationof intratumoral interferon alpha 2-b for cystic cranioparyngioma: a case report. International Journal of Case Reports and Images 4(12):719–722

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oncology, Royal Manchester Children’s Hospital, Manchester, UK

    John-Paul Kilday

  2. Department of Oncology, The Hospital for Sick Children, Toronto, ON, Canada

    Ute Bartels

Authors
  1. John-Paul Kilday
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ute Bartels
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ute Bartels .

Editor information

Editors and Affiliations

  1. Developmental Biology and Cancer Programme, Birth Defects Research Centre, Institute of Child Health, University College London, London, United Kingdom

    Juan Pedro Martinez-Barbera

  2. Craniofacial Development and Stem Cell Biology, King’s College London, London, United Kingdom

    Cynthia Lilian Andoniadou

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Kilday, JP., Bartels, U. (2017). Intracystic Administration of Interferon-Alpha for Reduction of Cystic Tumour Burden. In: Martinez-Barbera, J., Lilian Andoniadou, C. (eds) Basic Research and Clinical Aspects of Adamantinomatous Craniopharyngioma. Springer, Cham. https://doi.org/10.1007/978-3-319-51890-9_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-51890-9_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-51888-6

  • Online ISBN: 978-3-319-51890-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation