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Individualized treatment of craniopharyngioma in children: ways and means

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Abstract

Background

Medium- and long-term prognosis of craniopharyngioma is overwhelmed by the risks of hypothalamic and visual impairment. This problem has been underestimated for a long time because the major concern for the neurosurgeon was the risk of recurrences, their best prevention being thought to be complete tumour resection. Today, we know that radical surgery not only is not an absolute guarantee against recurrences but also can cause hypothalamic and visual complications.

Methods

The authors suggest that instead of complete removal, the first choice treatment should be, when possible, a less aggressive, multistaged and personalized treatment. In this perspective they focus on other therapeutic methods: endocavity treatment of cysts with rhenium-186, triconformational radiotherapy, radiosurgery, and widespread use of the trans-sphenoidal approach.

Conclusions

These simple methods should reduce the risks of visual aggravation and metabolic syndrome.

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Authors and Affiliations

  1. Unit of Paediatric Neurosurgery, Hôpital Central, 27 avenue de Lattre de Tassigny, 54000, Nancy, France

    J. C. Marchal & O. Klein

  2. Unit of Nuclear Medecine, Hôpital Central, 27 avenue de Lattre de Tassigny, 54000, Nancy, France

    P. Thouvenot

  3. Department of Radiation Therapy, Centre Alexis Vautrin, 54500, Vandoeuvre lès Nancy, France

    V. Bernier

  4. Department of Neuroradiology, Hôpital Central, 27 avenue de Lattre de Tassigny, 54000, Nancy, France

    C. Moret

  5. Department of Paediatric Oncology, Hôpital d’Enfant, 54500, Vandoeuvre lès Nancy, France

    P. Chastagner

Authors
  1. J. C. Marchal
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  2. O. Klein
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  3. P. Thouvenot
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  4. V. Bernier
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  5. C. Moret
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  6. P. Chastagner
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Correspondence to J. C. Marchal.

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Marchal, J.C., Klein, O., Thouvenot, P. et al. Individualized treatment of craniopharyngioma in children: ways and means. Childs Nerv Syst 21, 655–659 (2005). https://doi.org/10.1007/s00381-005-1211-8

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  • DOI: https://doi.org/10.1007/s00381-005-1211-8

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