TY - JOUR
T1 - Visual outcome, endocrine function and tumor control after fractionated stereotactic radiation therapy of craniopharyngiomas in adults
T2 - findings in a prospective cohort
AU - Astradsson, Arnar
AU - Munck Af Rosenschöld, Per
AU - Feldt-Rasmussen, Ulla
AU - Poulsgaard, Lars
AU - Wiencke, Anne Katrine
AU - Ohlhues, Lars
AU - Engelholm, Svend Aage
AU - Broholm, Helle
AU - Hansen Møller, Emil
AU - Klose, Marianne
AU - Roed, Henrik
AU - Juhler, Marianne
PY - 2017/3/4
Y1 - 2017/3/4
N2 - BACKGROUND: The purpose of this study was to examine visual outcome, endocrine function and tumor control in a prospective cohort of craniopharyngioma patients, treated with fractionated stereotactic radiation therapy (FSRT).MATERIAL AND METHODS: Sixteen adult patients with craniopharyngiomas were eligible for analysis. They were treated with linear accelerator-based FSRT during 1999-2015. In all cases, diagnosis was confirmed by histological analysis. The prescription dose to the tumor was 54 Gy (median, range 48-54) in 1.8 or 2.0 Gy per fraction, and the maximum radiation dose to the optic nerves and chiasm was 54.2 Gy (median, range 48.6-60.0) for the cohort. Serial ophthalmological and endocrine evaluations and magnetic resonance imaging (MRI) scans were performed at regular intervals. Median follow-up was 3.3 years (range 1.1-14.1), 3.7 years (range 0.8-15.2), and 3.6 years (range 0.7-13.1) for visual outcome, endocrine function, and tumor control, respectively.RESULTS: Visual acuity impairment was present in 10 patients (62.5%) and visual field defects were present in 12 patients (75%) before FSRT. One patient developed radiation-induced optic neuropathy at seven years after FSRT. Thirteen of 16 patients (81.3%) had pituitary deficiency before FSRT, and did not develop further pituitary deficiency after FSRT. Mean tumor volume pre-FSRT was 2.72 cm3(range 0.20-9.90) and post-FSRT 1.2 cm3(range 0.00-13.10). Tumor control rate was 81.3% at two, five, and 10 years after FSRT.CONCLUSIONS: FSRT was relatively safe in this prospective cohort of craniopharyngiomas, with only one case of radiation-induced optic neuropathy and no case of new endocrinopathy. Tumor control rate was acceptable.
AB - BACKGROUND: The purpose of this study was to examine visual outcome, endocrine function and tumor control in a prospective cohort of craniopharyngioma patients, treated with fractionated stereotactic radiation therapy (FSRT).MATERIAL AND METHODS: Sixteen adult patients with craniopharyngiomas were eligible for analysis. They were treated with linear accelerator-based FSRT during 1999-2015. In all cases, diagnosis was confirmed by histological analysis. The prescription dose to the tumor was 54 Gy (median, range 48-54) in 1.8 or 2.0 Gy per fraction, and the maximum radiation dose to the optic nerves and chiasm was 54.2 Gy (median, range 48.6-60.0) for the cohort. Serial ophthalmological and endocrine evaluations and magnetic resonance imaging (MRI) scans were performed at regular intervals. Median follow-up was 3.3 years (range 1.1-14.1), 3.7 years (range 0.8-15.2), and 3.6 years (range 0.7-13.1) for visual outcome, endocrine function, and tumor control, respectively.RESULTS: Visual acuity impairment was present in 10 patients (62.5%) and visual field defects were present in 12 patients (75%) before FSRT. One patient developed radiation-induced optic neuropathy at seven years after FSRT. Thirteen of 16 patients (81.3%) had pituitary deficiency before FSRT, and did not develop further pituitary deficiency after FSRT. Mean tumor volume pre-FSRT was 2.72 cm3(range 0.20-9.90) and post-FSRT 1.2 cm3(range 0.00-13.10). Tumor control rate was 81.3% at two, five, and 10 years after FSRT.CONCLUSIONS: FSRT was relatively safe in this prospective cohort of craniopharyngiomas, with only one case of radiation-induced optic neuropathy and no case of new endocrinopathy. Tumor control rate was acceptable.
KW - Adolescent
KW - Adult
KW - Aged
KW - Craniopharyngioma/pathology
KW - Dose Fractionation
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Pituitary Gland/physiology
KW - Pituitary Hormones/secretion
KW - Pituitary Neoplasms/pathology
KW - Radiosurgery/methods
KW - Radiotherapy Dosage
KW - Retrospective Studies
KW - Treatment Outcome
KW - Tumor Burden
KW - Vision, Ocular/physiology
KW - Young Adult
U2 - 10.1080/0284186x.2016.1270466
DO - 10.1080/0284186x.2016.1270466
M3 - Journal article
C2 - 28084862
SN - 0284-186X
VL - 56
SP - 415
EP - 421
JO - Acta Oncologica
JF - Acta Oncologica
IS - 3
ER -