Abstract
PURPOSE: To report long-term progression-free survival (PFS) and late-toxicity outcomes in pediatric craniopharyngioma patients treated with IMRT.
PATIENTS AND METHODS: Twenty-four children were treated with IMRT to a median dose of 50.4Gy (range, 49.8-54Gy). The clinical target volume (CTV) was the gross tumor volume (GTV) with a 1cm margin. The planning target volume (PTV) was the CTV with a 3-5mm margin. Median follow-up was 107.3months.
RESULTS: The 5- and 10-year PFS rates were 65.8% and 60.7%. The 5- and 10-year cystic PFS rates were 70.2% and 65.2% while the 5- and 10-year solid PFS were the same at 90.7%. Endocrinopathy was seen in 42% at initial diagnosis and in 74% after surgical intervention, prior to IMRT. Hypothalamic dysfunction and visual deficits were associated with increasing PTV and number of surgical interventions.
CONCLUSIONS: IMRT is a viable treatment option for pediatric craniopharyngioma. Despite the use of IMRT, majority of the craniopharyngioma patients experienced long-term toxicity, many of which present prior to radiotherapy. Limitations of retrospective analyses on small patient cohort elicit the need for a prospective multi-institutional study to determine the absolute benefit of IMRT in pediatric craniopharyngioma.
Original language | English (US) |
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Pages (from-to) | 224-9 |
Number of pages | 6 |
Journal | Radiotherapy and Oncology |
Volume | 114 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2015 |
Keywords
- Adolescent
- Child
- Child, Preschool
- Craniopharyngioma
- Disease-Free Survival
- Female
- Humans
- Male
- Pituitary Neoplasms
- Radiation Injuries
- Radiotherapy Dosage
- Radiotherapy Planning, Computer-Assisted
- Radiotherapy, Intensity-Modulated
- Retrospective Studies
- Survival Rate
- Treatment Outcome
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
- Hematology