Document Detail


Combined proton and photon irradiation for craniopharyngioma: long-term results of the early cohort of patients treated at Harvard Cyclotron Laboratory and Massachusetts General Hospital.
MedLine Citation:
PMID:  16580494     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We report the results of the early cohort of patients treated for craniopharyngioma with combined proton-photon irradiation at the Massachusetts General Hospital and the Harvard Cyclotron Laboratory. METHODS AND MATERIALS: Between 1981 and 1988, 15 patients with craniopharyngioma were treated in part or entirely with fractionated 160 MeV proton beam therapy. The group consisted of 5 children (median age, 15.9 years) and 10 adults (median age, 36.2 years). Median dose prescribed to the tumor was 56.9 cobalt Gray equivalent (CGE; 1 proton Gray = 1.1 CGE). The median proton component was 26.9 CGE. Patients were treated after documented recurrence after initial surgery (n = 6) or after subtotal resection or biopsy (n = 9). None had had prior radiation therapy. RESULTS: Median observation period of surviving patients (n = 11) was 13.1 years from radiotherapy. One patient was lost to follow-up with tumor control after 5.2 years. Actuarial 10-year survival rate was 72%. Four patients have died 5-9.1 years after treatment, two from local failure. Actuarial 5- and 10-year local control rates were 93% and 85%, respectively. The functional status of the living adult patients is unaltered from their preradiotherapy status; all of them continued leading normal or near normal working lives. None of the patients treated as a child had experienced recurrence of tumor. One child shows learning difficulties and slight retardation, comparable to his preradiotherapy status. The others have professional achievements within the normal range. CONCLUSION: Results in terms of survival and local control are comparable with other contemporary series. Although no formal neuropsychological testing was performed, the surrogate measures of lifestyle and professional accomplishments appear to be satisfactory.
Authors:
Markus M Fitzek; Rita M Linggood; Judy Adams; John E Munzenrider
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  64     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-03     Completed Date:  2006-05-01     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1348-54     Citation Subset:  IM    
Affiliation:
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Achievement
Adolescent
Adult
Child
Craniopharyngioma / mortality,  radiotherapy*
Cyclotrons
Educational Status
Female
Humans
Male
Middle Aged
Photons / therapeutic use*
Pituitary Neoplasms / mortality,  radiotherapy*
Protons / therapeutic use*
Survival Rate
Thyroid Hormones / administration & dosage
Visual Fields / radiation effects
Grant Support
ID/Acronym/Agency:
P01 CA 21239/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Protons; 0/Thyroid Hormones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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