CRAN-35. CHILDHOOD CYSTIC CRANIOPHARYNGIOMA: 15 YEARS OF INTRA-TUMORAL CHEMOTHERAPY WITH INTERFERON-ALPHA AT IOP/GRAACC/UNIFESP

INTRODUCTION: Management of patients with craniopharyngioma is still controversial. Currently, quality of life is the goal for all treatment modalities. OBJECTIVE: To analyze the several treatment strategies and outcomes of craniopharyngioma patients in 15 years of experience in a single institution. METHODS: The authors retrospectively evaluated 110 craniopharyngeoma patients treated between 2002 and 2017, at IOP/GRAACC/UNIFESP. Data regarding initial clinical presentation, body mass index (BMI), endocrinological complications, treatment modalities and outcomes were collected. RESULTS: From 110 patients, 95 patients were eligible for evaluation. Fifty-five were boys and 40 girls. The mean age at treatment was 10,5 years. Fifty-six percent of children presented with signs and symptoms of intracranial hypertension, 24% with visual impairment and 38,5% with endocrinological disturbances. At the time of diagnosis, the mean BMI was 20,48kg/m(2). Thirty-eight children with cystic tumors were treated with intralesional interferon-alpha, 13 progressed to conventional treatment. Among the remaining 57 patients, 9 were treated with microsurgery, 29 with microsurgery + radiotherapy, 12 with endoscopic transesphenoidal surgery + radiotherapy and 7 recurrent patients with intracystic interferon-alpha. The mean BMI of patients treated exclusively with interferon-alpha was 22,88kg/m(2) (ideal weight) and with microsurgery + radiotherapy was 29,65kg/m(2) (overweight). After treatment, 61 cases (65%) progressed to panhypopituitarism. The mean follow up was 7,13 years. Eleven deaths occurred. Currently 41 patients are out of treatment. CONCLUSION: The interferon-alpha intracystic therapy has been shown to be effective in the control of predominantly cystic tumors, decreasing or delaying the morbidity from conventional treatment.