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Clinical outcomes following proton therapy for adult craniopharyngioma: a single-institution cohort study.
- Source :
-
Journal of neuro-oncology [J Neurooncol] 2020 Apr; Vol. 147 (2), pp. 387-395. Date of Electronic Publication: 2020 Feb 21. - Publication Year :
- 2020
-
Abstract
- Background: Craniopharyngioma is a benign tumor that commonly develops within the suprasellar region. The tumor and treatment can have debilitating consequences for pediatric and adult patients, including vision loss and pituitary/hypothalamic dysfunction. Most craniopharyngioma series focus on treatment of the pediatric population. We evaluated the outcomes of all adult craniopharyngioma patients treated at our institution using proton therapy to report outcomes for disease control, treatment-related toxicity, and tumor response.<br />Methods: We analyzed 14 adult patients (≥ 22 years old). All patients had gross disease at the time of radiotherapy. Five were treated for de novo disease and 9 for recurrent disease. Patients received double-scattered conformal proton therapy to a mean dose of 54 GyRBE in 1.8 GyRBE/fraction (range 52.2-54 GyRBE). Weekly magnetic resonance imaging (MRI) helped to evaluate tumor changes during radiotherapy.<br />Results: With median clinical and radiographic follow-up of 29 and 26 months, respectively, the 3-year local control and overall survival rates were both 100%. There were no grade 3 or greater acute or late radiotherapy-related side effects. There was no radiotherapy-related vision loss or optic neuropathy. No patients required intervention or treatment replanning due to tumor changes during radiotherapy. Two patients experienced transient cyst expansion at their first post-radiotherapy MRI. Both patients were followed closely clinically and radiographically and had subsequent dramatic tumor/cyst regression, requiring no interventions.<br />Conclusions: Our data support the safety and efficacy of proton therapy in the treatment of adult craniopharyngioma as part of primary or salvage treatment. We recommend early consideration of radiotherapy. This trial was registered at www.clinicaltrials.gov as #NCT03224767.
- Subjects :
- Adult
Craniopharyngioma pathology
Craniopharyngioma radiotherapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pituitary Neoplasms pathology
Pituitary Neoplasms radiotherapy
Prognosis
Retrospective Studies
Survival Rate
Young Adult
Craniopharyngioma mortality
Pituitary Neoplasms mortality
Proton Therapy mortality
Radiotherapy, Conformal mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7373
- Volume :
- 147
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of neuro-oncology
- Publication Type :
- Academic Journal
- Accession number :
- 32086697
- Full Text :
- https://doi.org/10.1007/s11060-020-03432-9