Long-term disease control and toxicity outcomes following surgery and intensity modulated radiation therapy (IMRT) in pediatric craniopharyngioma

Brad J Greenfield, Mehmet F Okcu, Patricia A Baxter, Murali Chintagumpala, Bin S Teh, Robert C Dauser, Jack Su, Snehal S Desai, Arnold C Paulino

Research output: Contribution to journalArticle

29 Scopus citations

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 languageEnglish (US)
Pages (from-to)224-9
Number of pages6
JournalRadiotherapy and Oncology
Volume114
Issue number2
DOIs
StatePublished - 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

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