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Stereotactic radiosurgery for craniopharyngiomas

  • Original Article - Brain Tumors
  • Published:
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Abstract

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.

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References

  1. Chiou SM, Lunsford LD, Niranjan A, Kondziolka D, Flickinger JC (2001) Stereotactic radiosurgery of residual or recurrent craniopharyngioma, after surgery, with or without radiation therapy. Neuro Oncol 3(3):159–166

    Article  CAS  Google Scholar 

  2. Chung W-Y, Pan DH-C, Shiau C-Y, Guo W-Y, Wang L-W (2000) Gamma knife radiosurgery for craniopharyngiomas. J Neurosurg 93(supplement_3):47–56

    Article  Google Scholar 

  3. Dho Y-S, Kim YH, Kim JW, Park C-K, Chung H-T, Kim S-K, Paek SH, Wang K-C, Kim DG (2018) Optimal strategy of gamma knife radiosurgery for craniopharyngiomas. J Neurooncol 140(1):135–143

    Article  CAS  Google Scholar 

  4. Effenterre RV, Boch A-L (2002) Craniopharyngioma in adults and children: a study of 122 surgical cases. J Neurosurg 97(1):3–11

    Article  Google Scholar 

  5. Fahlbusch R, Honegger J, Paulus W, Huk W, Buchfelder M (1999) Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 90(2):237–250

    Article  CAS  Google Scholar 

  6. Gopalan R, Dassoulas K, Rainey J, Sherman JH, Sheehan JP (2008) Evaluation of the role of Gamma Knife surgery in the treatment of craniopharyngiomas. Neurosurg Focus 24(5):E5

    Article  Google Scholar 

  7. Hasegawa T, Kobayashi T, Kida Y (2010) Tolerance of the optic apparatus in single-fraction irradiation using stereotactic radiosurgery: evaluation in 100 patients with craniopharyngioma. Neurosurgery 66(4):688–694; discussion 694-695

    Article  Google Scholar 

  8. Hoffman HJ, Silva MD, Humphreys RP, Drake JM, Smith ML, Blaser SI (1992) Aggressive surgical management of craniopharyngiomas in children. J Neurosurg 76(1):47–52

    Article  CAS  Google Scholar 

  9. Jane JA, Laws ER (2006) Craniopharyngioma Pituitary 9(4):323–326

    Article  Google Scholar 

  10. Kalapurakal JA, Goldman S, Hsieh YC, Tomita T, Marymont MH (2003) Clinical outcome in children with craniopharyngioma treated with primary surgery and radiotherapy deferred until relapse. Med Pediatr Oncol 40(4):214–218

    Article  Google Scholar 

  11. Karavitaki N, Brufani C, Warner JT, Adams CBT, Richards P, Ansorge O, Shine B, Turner HE, Wass JaH (2005) Craniopharyngiomas in children and adults: systematic analysis of 121 cases with long-term follow-up. Clin Endocrinol (Oxf) 62(4):397–409

    Article  CAS  Google Scholar 

  12. Kim SK, Wang KC, Shin SH, Choe G, Chi JG, Cho BK (2001) Radical excision of pediatric craniopharyngioma: recurrence pattern and prognostic factors. Childs Nerv Syst 17(9):531–536; discussion 537

    Article  CAS  Google Scholar 

  13. Kobayashi T, Kida Y, Mori Y, Hasegawa T (2005) Long-term results of gamma knife surgery for the treatment of craniopharyngioma in 98 consecutive cases. J Neurosurg 103(6 Suppl):482–488

    PubMed  Google Scholar 

  14. Kobayashi T, Tsugawa T, Hatano M, Hashizume C, Mori Y, Shibamoto Y (2015) Gamma knife radiosurgery of craniopharyngioma: results of 30 cases treated at Nagoya Radiosurgery Center. Nagoya J Med Sci 77(3):447–454

    PubMed  PubMed Central  Google Scholar 

  15. Lee C-C, Yang H-C, Chen C-J, Hung Y-C, Wu H-M, Shiau C-Y, Guo W-Y, Pan DH-C, Chung W-Y, Liu K-D (2014) Gamma Knife surgery for craniopharyngioma: report on a 20-year experience. J Neurosurg 121(Suppl):167–178

    Article  Google Scholar 

  16. Lin LL, Naqa IE, Leonard JR, Park TS, Hollander AS, Michalski JM, Mansur DB (2008) Long-term outcome in children treated for craniopharyngioma with and without radiotherapy. J Neurosurg Pediatr 1(2):126–130

    Article  Google Scholar 

  17. Losa M, Pieri V, Bailo M, Gagliardi F, Barzaghi LR, Gioia L, Del Vecchio A, Bolognesi A, Mortini P (2018) Single fraction and multisession Gamma Knife radiosurgery for craniopharyngioma. Pituitary 21(5):499–506

    Article  Google Scholar 

  18. Maira G, Anile C, Rossi GF, Colosimo C (1995) Surgical treatment of craniopharyngiomas: an evaluation of the transsphenoidal and pterional approaches. Neurosurgery 36(4):715–724

    Article  CAS  Google Scholar 

  19. Müller HL (2014) Craniopharyngioma. Endocr Rev 35(3):513–543

    Article  CAS  Google Scholar 

  20. Müller HL, Merchant TE, Warmuth-Metz M, Martinez-Barbera J-P, Puget S (2019) Craniopharyngioma. Nat Rev Dis Primers 5(1):1–19

    Article  Google Scholar 

  21. Niranjan A, Kano H, Mathieu D, Kondziolka D, Flickinger JC, Lunsford LD (2010) Radiosurgery for craniopharyngioma. Int J Radiat Oncol Biol Phys 78(1):64–71

    Article  Google Scholar 

  22. Ogino A, Lunsford LD, Long H, Johnson S, Faramand A, Niranjan A, Flickinger JC, Kano H (2021) Stereotactic radiosurgery as the primary management for patients with Koos grade IV vestibular schwannomas. J Neurosurg 1(aop):1–9

    Article  Google Scholar 

  23. Ogino A, Niranjan A, Kano H, Flickinger JC, Lunsford LD (2021) Optimizing stereotactic radiosurgery in patients with recurrent or residual craniopharyngiomas. J Neurooncol. https://doi.org/10.1007/s11060-021-03806-7

    Article  PubMed  Google Scholar 

  24. Saleem MA, Hashim ASM, Rashid A, Ali M (2013) Role of gamma knife radiosurgery in multimodality management of craniopharyngioma. Acta Neurochir Suppl 116:55–60

    PubMed  Google Scholar 

  25. Schoenfeld A, Pekmezci M, Barnes MJ et al (2012) The superiority of conservative resection and adjuvant radiation for craniopharyngiomas. J Neurooncol 108(1):133–139

    Article  Google Scholar 

  26. Stripp DCH, Maity A, Janss AJ et al (2004) Surgery with or without radiation therapy in the management of craniopharyngiomas in children and young adults. Int J Radiat Oncol Biol Phys 58(3):714–720

    Article  Google Scholar 

  27. Tsugawa T, Kobayashi T, Hasegawa T et al (2020) Gamma Knife surgery for residual or recurrent craniopharyngioma after surgical resection: a multi-institutional retrospective study in Japan. Cureus 12(2):e6973

    PubMed  PubMed Central  Google Scholar 

  28. Ulfarsson E, Lindquist C, Roberts M, Rähn T, Lindquist M, Thorén M, Lippitz B (2002) Gamma knife radiosurgery for craniopharyngiomas: long-term results in the first Swedish patients. J Neurosurg 97(5 Suppl):613–622

    Article  Google Scholar 

  29. Varlotto J, DiMaio C, Grassberger C et al (2016) Multi-modality management of craniopharyngioma: a review of various treatments and their outcomes. Neurooncol Pract 3(3):173–187

    PubMed  Google Scholar 

  30. Xu Z, Yen C-P, Schlesinger D, Sheehan J (2011) Outcomes of Gamma Knife surgery for craniopharyngiomas. J Neurooncol 104(1):305–313

    Article  CAS  Google Scholar 

  31. Yang I, Sughrue ME, Rutkowski MJ, Kaur R, Ivan ME, Aranda D, Barani IJ, Parsa AT (2010) Craniopharyngioma: a comparison of tumor control with various treatment strategies. Neurosurg Focus 28(4):E5

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neurological Surgery, University of Virginia Health System, Box 800212, Charlottesville, VA, 22908, USA

    Stylianos Pikis & Jason Sheehan

  2. Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA, USA

    Georgios Mantziaris, Karen Lavezzo & Nisha Dabhi

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  1. Stylianos Pikis
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  2. Georgios Mantziaris
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Correspondence to Jason Sheehan.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Pikis, S., Mantziaris, G., Lavezzo, K. et al. Stereotactic radiosurgery for craniopharyngiomas. Acta Neurochir 163, 3201–3207 (2021). https://doi.org/10.1007/s00701-021-04990-1

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  • DOI: https://doi.org/10.1007/s00701-021-04990-1

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