Document Detail


Surgery and radiation therapy in the management of craniopharyngiomas.
MedLine Citation:
PMID:  6511526     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Twenty-nine patients with histologically confirmed craniopharyngioma were treated from 1960 to 1978, inclusive. Twelve patients were below the age of 15 years, the remaining were adults. Seventy-five percent (9/12) of the patients below the age of 15 showed increased intracranial pressure at presentation and 58% (7/12) showed visual disturbances. In the adult group, 47% (8/17) presented with increased intracranial pressure and 88% (15/17) with visual disturbances. Hormonal, mental and behavior changes were almost equally distributed in both age groups. All patients underwent craniotomy, with subtotal resection of the tumor. Three adults died of postoperative complications (10%), of whom two died of pulmonary emboli and one of cerebral hemorrhage. Of the remaining 26 patients, 13 received immediate postoperative radiotherapy to a total dose of 50.0 to 56.0 Gy, in a target volume including the sellar and parasellar region during an overall treatment period of five to six weeks. All patients were evaluable with a minimum follow-up of four years since they finished their treatment or until death. The five-year recurrence-rate in the group that did not receive postoperative radiation therapy was 45% (5/11 patients) and the five-year rate of death of disease in this group was 27% (3/11 patients). For the group that received immediate postoperative radiation therapy the five-year recurrence-rate was 11% (1/9 patients) and no death of disease was observed in this group. This difference between the two groups was not significant. The corresponding 10-year rates were 71% (5/7 patients) for recurrence and 57% (4/7 patients) for death of disease in the group without, and in the group with immediate postoperative radiation therapy the rate was 25% (2/8 patients) for recurrence and 0 for death of disease. This difference turns out to be significant. Critical analysis of the morbidity in patients surviving after treatment showed no adverse effect on the visual or endocrine status of the group that received postoperative irradiation. It is concluded that in the management of patients with craniopharyngiomas, postoperative irradiation after subtotal resection improves the prognosis of the patient and does not add to visual or endocrine morbidity.
Authors:
J Hoogenhout; B J Otten; I Kazem; G B Stoelinga; A H Walder
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  10     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  1984 Dec 
Date Detail:
Created Date:  1985-02-15     Completed Date:  1985-02-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2293-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Child, Preschool
Combined Modality Therapy
Craniopharyngioma / radiotherapy,  surgery,  therapy*
Craniotomy
Female
Humans
Male
Middle Aged
Pituitary Neoplasms / radiotherapy,  surgery,  therapy*
Prognosis
Retrospective Studies

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


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