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Neuroendoscopy Followed by Radiotherapy in Cystic Craniopharyngiomas--a Long-Term Follow-Up.
- Source :
-
World neurosurgery [World Neurosurg] 2015 Nov; Vol. 84 (5), pp. 1305-15.e1-2. Date of Electronic Publication: 2015 Jun 20. - Publication Year :
- 2015
-
Abstract
- Background: Treatment of cystic craniopharyngiomas is often complicated because of adherence of craniopharyngiomas to adjacent brain structures. A strategy involving neuroendoscopic procedures followed by stereotactic radiotherapy is less invasive, avoiding brain damage. However, long-term follow-up of this strategy has not been investigated in depth.<br />Methods: Cystic craniopharyngiomas in 9 patients were treated with neuroendoscopic cyst aspiration and fenestration, followed by fractionated stereotactic radiotherapy (FSRT). The neuroendoscopic procedure focused on widening of cyst fenestration and extensive irrigation of the cyst contents. FSRT was performed using 6 fixed beams, an 8-mm margin to cover the gross tumor volume with a 95% isodose line, and a target delivered dose of 50.4 Gy in 28 fractions.<br />Results: The median follow-up period was 72.9 months. Tumor control was achieved in 8 of 9 patients (88.9%). Marked tumor volume reduction was obtained with the neuroendoscopic procedure alone (26.1%) at 6 months (20.4%), 1 year (11.0%), and 2 years (3.1%). One recurrent case showed multilobulated cysts, and a second surgery was required 1 year after the treatment. Clinical symptoms such as headache and visual disruption were rapidly alleviated after the neuroendoscopic procedure. No new visual disturbances, endocrinopathy, or hypothalamic dysfunction was observed during follow up.<br />Conclusions: Neuroendoscopic cyst aspiration and fenestration followed by FSRT is a less invasive, powerful strategy for treating adult cystic craniopharyngiomas.<br /> (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Biopsy
Craniopharyngioma pathology
Female
Follow-Up Studies
Headache etiology
Humans
Hypopituitarism etiology
Magnetic Resonance Imaging
Male
Memory Disorders etiology
Middle Aged
Neoplasm Recurrence, Local
Pituitary Hormones blood
Pituitary Neoplasms pathology
Retrospective Studies
Suction
Visual Acuity
Craniopharyngioma surgery
Neuroendoscopy methods
Pituitary Neoplasms surgery
Radiosurgery methods
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 84
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 26100163
- Full Text :
- https://doi.org/10.1016/j.wneu.2015.06.022