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Radiation Therapy in Craniopharyngioma

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Abstract

Craniopharyngioma are rare intracranial, perisellar tumors of adamantinomatous or papillary subtype. Alhough “benign” in nature they might lead to devastating deficits or death in children or adults. After surgical resection local failure occurs frequently. Definitive/adjuvant radiation therapy or treatment at relapse yields high local control rates and long overall survival. Radicality of resection and timing of radiotherapy must be balanced against side effects. Fractionated intensity modulated radiotherapy (IMRT) and fractionated stereotactic radiotherapy or proton-treatment are preferential radiation techniques.

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References

  • Adamson TE, Wiestler OD, Kleihues P, Yaşargil MG. Correlation of clinical and pathological features in surgically treated craniopharyngiomas. J Neurosurg. 1990;73:12–7.

    Article  CAS  PubMed  Google Scholar 

  • Aggarwal A, Fersht N, Brada M. Radiotherapy for craniopharyngioma. Pituitary. 2013;16:26–33.

    Article  PubMed  Google Scholar 

  • Astradsson A, Munck Af Rosenschöld P, Feldt-Rasmussen U, Poulsgaard L, Wiencke AK, Ohlhues L, Engelholm SA, Broholm H, Hansen Møller E, Klose M, et al. Visual outcome, endocrine function and tumor control after fractionated stereotactic radiation therapy of craniopharyngiomas in adults: findings in a prospective cohort. Acta Oncol. 2017;56:415–21.

    Article  PubMed  Google Scholar 

  • Beltran C, Roca M, Merchant TE. On the benefits and risks of proton therapy in pediatric craniopharyngioma. Int J Radiat Oncol Biol Phys. 2012;82:e281–7.

    Article  PubMed  Google Scholar 

  • Bishop AJ, Greenfield B, Mahajan A, Paulino AC, Okcu MF, Allen PK, Chintagumpala M, Kahalley LS, McAleer MF, McGovern SL, et al. Proton beam therapy versus conformal photon radiation therapy for childhood craniopharyngioma: multi-institutional analysis of outcomes, cyst dynamics, and toxicity. Int J Radiat Oncol Biol Phys. 2014;90:354–61.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brastianos PK, Taylor-Weiner A, Manley PE, Jones RT, Dias-Santagata D, Thorner AR, Lawrence MS, Rodriguez FJ, Bernardo LA, Schubert L, et al. Exome sequencing identifies BRAF mutations in papillary craniopharyngiomas. Nat Genet. 2014;46(2):161–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Brastianos PK, Shankar GM, Gill CM, Taylor-Weiner A, Nayyar N, Panka DJ, Sullivan RJ, Frederick DT, Abedalthagafi M, Jones PS, et al. Dramatic response of BRAF V600E mutant papillary craniopharyngioma to targeted therapy. J Natl Cancer Inst. 2016;108(2).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM. The descriptive epidemiology of craniopharyngioma. J Neurosurg. 1998;89:547–51.

    Article  CAS  PubMed  Google Scholar 

  • Buslei R, Nolde M, Hofmann B, Meissner S, Eyupoglu IY, Siebzehnrübl F, Hahnen E, Kreutzer J, Fahlbusch R. Common mutations of beta-catenin in adamantinomatous craniopharyngiomas but not in other tumours originating from the sellar region. Acta Neuropathol. 2005;109:589–97.

    Article  CAS  PubMed  Google Scholar 

  • Cavallo LM, Solari D, Esposito F, Villa A, Minniti G, Cappabianca P. The role of the endoscopic endonasal route in the management of craniopharyngiomas. World Neurosurg. 2014;82:S32–40.

    Article  PubMed  Google Scholar 

  • Combs SE, Thilmann C, Huber PE, Hoess A, Debus J, Schulz-Ertner D. Stephanie E. Combs, Christoph Thilmann, Peter E. Huber, Angelika Hoess, Jürgen Debus, Daniela Schulz-Ertner, Achievement of long-term. local control in patients with craniopharyngiomas using high precision stereotactic radiotherapy. Cancer. 2007;109 (11):2308–2314.

    Article  PubMed  Google Scholar 

  • Dandurand C, Sepehry AA, Asadi Lari MH, Akagami R, Gooderham P. Adult craniopharyngioma: case series, systematic review, and meta-analysis. Neurosurgery. 2017;0:0–11.

    Google Scholar 

  • Dhandapani S, Singh H, Negm HM, Cohen S, Souweidane MM, Greenfield JP, Anand VK, Schwartz TH. Endonasal endoscopic reoperation for residual or recurrent craniopharyngiomas. J Neurosurg. 2017;126:418–30.

    Article  PubMed  Google Scholar 

  • Elliott RE, Wisoff JH, Successful surgical treatment of craniopharyngioma in very young children. Journal of Neurosurgery: Pediatrics 3. 2009;(5):397–406.

    PubMed  Google Scholar 

  • Fitzek MM, Linggood RM, Adams J, Munzenrider JE. 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. Int J Radiat Oncol Biol Phys. 2006;64:1348–54.

    Article  PubMed  Google Scholar 

  • Greenfield BJ, Okcu MF, Baxter PA, Chintagumpala M, Teh BS, Dauser RC, Su J, Desai SS, Paulino AC. Long-term disease control and toxicity outcomes following surgery and intensity modulated radiation therapy (IMRT) in pediatric craniopharyngioma. Radiother Oncol. 2015;114:224–9.

    Article  PubMed  Google Scholar 

  • Harrabi SB, Adeberg S, Welzel T, Rieken S, Habermehl D, Debus J, Combs SE, Long term results after fractionated stereotactic radiotherapy (FSRT) in patients with craniopharyngioma: maximal tumor control with minimal side effects. Radiation Oncology. 2014;9 (1):203.

    Article  PubMed  Google Scholar 

  • Hashizume C, Mori Y, Kobayashi T, Shibamoto Y, Nagai A, Hayashi N, Stereotactic radiotherapy using Novalis for craniopharyngioma adjacent to optic pathways. Journal of Neuro-Oncology. 2010;98 (2):239–247.

    Article  PubMed  Google Scholar 

  • Hetelekidis S, Barnes PD, Tao ML, Fischer EG, Schneider L, Scott RM, Tarbell NJ. 20-year experience in childhood craniopharyngioma. Int J Radiat Oncol Biol Phys. 1993;27:189–95.

    Article  CAS  PubMed  Google Scholar 

  • Hoffmann A, Warmth-Metz M, Gebhardt U, Pietsch T, Pohl F, Kortmann R-D, Calaminus G, Müller HL. Childhood craniopharyngioma – changes of treatment strategies in the trials KRANIOPHARYNGEOM 2000/2007. Klin Padiatr. 2014;226:161–8.

    Article  CAS  PubMed  Google Scholar 

  • Jeon C, Kim S, Shin HJ, Nam D-H, Lee J-I, Park K, Kim JH, Jeon B, Kong D-S. The therapeutic efficacy of fractionated radiotherapy and gamma-knife radiosurgery for craniopharyngiomas. J Clin Neurosci. 2011;18:1621–5.

    Article  PubMed  Google Scholar 

  • Kanesaka N, Mikami R, Nakayama H, Nogi S, Yu T, Nakajima N, Wada J, Miki T, Haraoka J, Okubo M, Sugahara S, Tokuuye K, Preliminary Results of Fractionated Stereotactic Radiotherapy After Cyst Drainage for Craniopharyngioma in Adults. International Journal of Radiation Oncology*Biology*Physics. 2012;82 (4):1356–1360.

    Article  Google Scholar 

  • Kilday J-P, Caldarelli M, Massimi L, Chen RH-H, Lee YY, Liang M-L, Parkes J, Naiker T, van Veelen M-L, Michiels E, et al. Intracystic interferon-alpha in pediatric craniopharyngioma patients: an international multicenter assessment on behalf of SIOPE and ISPN. Neuro-Oncology. 2017;19:1398–407.

    Article  PubMed  Google Scholar 

  • Kim MS, Kim YS, Lee HK, Lee GJ, Choi CY, Lee CH. Primary intracranial ectopic craniopharyngioma in a patient with probable Gardner’s syndrome. J Neurosurg. 2014;120:337–41.

    Article  PubMed  Google Scholar 

  • Koral K, Weprin B, Rollins NK. Sphenoid sinus craniopharyngioma simulating mucocele. Acta Radiol. 2006;1987(47):494–6.

    Article  Google Scholar 

  • Lamiman K, Wong KK, Tamrazi B, Nosrati JD, Olch A, Chang EL, Kiehna EN. A quantitative analysis of craniopharyngioma cyst expansion during and after radiation therapy and surgical implications. Neurosurg Focus. 2016;41:E15.

    Article  PubMed  Google Scholar 

  • Larkin SJ, Preda V, Karavitaki N, Grossman A, Ansorge O. BRAF V600E mutations are characteristic for papillary craniopharyngioma and may coexist with CTNNB1-mutated adamantinomatous craniopharyngioma. Acta Neuropathol. 2014;127:927–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Leber KA, Berglöff J, Pendl G. Dose-response tolerance of the visual pathways and cranial nerves of the cavernous sinus to stereotactic radiosurgery. J Neurosurg. 1998;88:43–50.

    Article  CAS  PubMed  Google Scholar 

  • Lin LL, El Naqa I, Leonard JR, Park TS, Hollander AS, Michalski JM, Mansur DB. Long-term outcome in children treated for craniopharyngioma with and without radiotherapy. J Neurosurg Pediatr. 2008;1:126–30.

    Article  PubMed  Google Scholar 

  • Lo AC, Fuchsia Howard A, Nichol A, Hasan H, Martin M, Heran M, Goddard K, A Cross-Sectional Cohort Study of Cerebrovascular Disease and Late Effects After Radiation Therapy for Craniopharyngioma. Pediatric Blood & Cancer. 2016;63 (5):786–793.

    Article  CAS  Google Scholar 

  • Louis DN, Ohgaki H, Wiestler OD, Cavenee WK. WHO classification of tumours of the central nervous system. 2016, 4rth Edition, Volume 1 

    Google Scholar 

  • Luu QT, Loredo LN, Archambeau JO, Yonemoto LT, Slater JM, Slater JD. Fractionated proton radiation treatment for pediatric craniopharyngioma: preliminary report. Cancer J. 2006;12:155–9.

    PubMed  Google Scholar 

  • Mayo C, Martel MK, Marks LB, Flickinger J, Nam J, Kirkpatrick J. Radiation dose-volume effects of optic nerves and chiasm. Int J Radiat Oncol Biol Phys. 2010;76:S28–35.

    Article  PubMed  Google Scholar 

  • Merchant TE, Kiehna EN, Kun LE, Mulhern RK, Li C, Xiong X, Boop FA, Sanford RA. Phase II trial of conformal radiation therapy for pediatric patients with craniopharyngioma and correlation of surgical factors and radiation dosimetry with change in cognitive function. J Neurosurg. 2006;104:94–102.

    PubMed  Google Scholar 

  • Merchant TE, Hua C-H, Shukla H, Ying X, Nill S, Oelfke U. Proton versus photon radiotherapy for common pediatric brain tumors: comparison of models of dose characteristics and their relationship to cognitive function. Pediatr Blood Cancer. 2008;51:110–7.

    Article  PubMed  Google Scholar 

  • Merchant TE, Kun LE, Hua C-H, Wu S, Xiong X, Sanford RA, Boop FA. Disease control after reduced volume conformal and intensity modulated radiation therapy for childhood craniopharyngioma. Int J Radiat Oncol Biol Phys. 2013;85:e187–92.

    Article  PubMed  Google Scholar 

  • Minniti G, Saran F, Traish D, Soomal R, Sardell S, Gonsalves A, Ashley S, Warrington J, Burke K, Mosleh-Shirazi A, Brada M, Fractionated stereotactic conformal radiotherapy following conservative surgery in the control of craniopharyngiomas. Radiotherapy and Oncology. 2007;82 (1):90–95.

    Article  PubMed  Google Scholar 

  • Minniti G, Esposito V, Amichetti M, Enrici RM. The role of fractionated radiotherapy and radiosurgery in the management of patients with craniopharyngioma. Neurosurg Rev. 2009;32:125–32; discussion 132.

    Article  CAS  PubMed  Google Scholar 

  • Minniti G, Traish D, Ashley S, Gonsalves A, Brada M. Risk of second brain tumor after conservative surgery and radiotherapy for pituitary adenoma: update after an additional 10 years. J Clin Endocrinol Metab. 2005;90:800–4.

    Article  CAS  PubMed  Google Scholar 

  • Moon SH, Kim IH, Park SW, Kim I, Hong S, Park CI, Wang KC, Cho BK. Early adjuvant radiotherapy toward long-term survival and better quality of life for craniopharyngiomas–a study in single institute. Childs Nerv Syst. 2005;21:799–807.

    Article  PubMed  Google Scholar 

  • Nielsen EH, Feldt-Rasmussen U, Poulsgaard L, Kristensen LO, Astrup J, Jørgensen JO, Bjerre P, Andersen M, Andersen C, Jørgensen J, et al. Incidence of craniopharyngioma in Denmark (n = 189) and estimated world incidence of craniopharyngioma in children and adults. J Neuro-Oncol. 2011;104:755–63.

    Article  CAS  Google Scholar 

  • Pemberton LS, Dougal M, Magee B, Gattamaneni HR. Experience of external beam radiotherapy given adjuvantly or at relapse following surgery for craniopharyngioma. Radiother Oncol. 2005;77:99–104.

    Article  PubMed  Google Scholar 

  • Rostami E, Witt Nyström P, Libard S, Wikström J, Casar-Borota O, Gudjonsson O. Recurrent papillary craniopharyngioma with BRAFV600E mutation treated with neoadjuvant-targeted therapy. Acta Neurochir. 2017;159:2217–21.

    Article  PubMed  Google Scholar 

  • Sartoretti-Schefer S, Wichmann W, Aguzzi A, Valavanis A. MR differentiation of adamantinous and squamous-papillary craniopharyngiomas. AJNR Am J Neuroradiol. 1997;18:77–87.

    PubMed  CAS  Google Scholar 

  • Schweizer L, Capper D, Hölsken A, Fahlbusch R, Flitsch J, Buchfelder M, Herold-Mende C, von Deimling A, Buslei R, Neuropathology and Applied Neurobiology. 2015;41 (6):733–742.

    Article  CAS  Google Scholar 

  • Shi Z, Esiashvili N, Janss AJ, Mazewski CM, MacDonald TJ, Wrubel DM, Brahma B, Schwaibold FP, Marcus RB, Crocker IR, et al. Transient enlargement of craniopharyngioma after radiation therapy: pattern of magnetic resonance imaging response following radiation. J Neuro-Oncol. 2012;109:349–55.

    Article  CAS  Google Scholar 

  • Stephen F. Kralik, Gordon A. Watson, Chie-Schin Shih, Chang Y. Ho, Whitney Finke, Jeffrey Buchsbaum, Radiation-Induced Large Vessel Cerebral Vasculopathy in Pediatric Patients With Brain Tumors Treated With Proton Radiation Therapy. International Journal of Radiation Oncology*Biology*Physics. 2017;99 (4):817–824.

    Article  Google Scholar 

  • Sterkenburg AS, Hoffmann A, Gebhardt U, Warmuth-Metz M, Daubenbüchel AMM, Müller HL. Survival, hypothalamic obesity, and neuropsychological/psychosocial status after childhood-onset craniopharyngioma: newly reported long-term outcomes. Neuro-Oncology. 2015;17:1029–38.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stripp DCH, Maity A, Janss AJ, Belasco JB, Tochner ZA, Goldwein JW, Moshang T, Rorke LB, Phillips PC, Sutton LN, et al. Surgery with or without radiation therapy in the management of craniopharyngiomas in children and young adults. Int J Radiat Oncol Biol Phys. 2004;58:714–20.

    Article  PubMed  Google Scholar 

  • Thomsett MJ, Conte FA, Kaplan SL, Grumbach MM. Endocrine and neurologic outcome in childhood craniopharyngioma: review of effect of treatment in 42 patients. J Pediatr. 1980;97:728–35.

    Article  CAS  PubMed  Google Scholar 

  • Tishler RB, Loeffler JS, Lunsford LD, Duma C, Alexander E, Kooy HM, Flickinger JC. Tolerance of cranial nerves of the cavernous sinus to radiosurgery. Int J Radiat Oncol Biol Phys. 1993;27:215–21.

    Article  CAS  PubMed  Google Scholar 

  • Tomita T, Bowman RM. Craniopharyngiomas in children: surgical experience at Children’s Memorial Hospital. Childs Nerv Syst. 2005;21:729–46.

    Article  PubMed  Google Scholar 

  • Van Effenterre R, Boch A-L. Craniopharyngioma in adults and children: a study of 122 surgical cases. J Neurosurg. 2002;97:3–11.

    Article  PubMed  Google Scholar 

  • Vanhauwaert D, Hallaert G, Baert E, Van Roost D, Okito J-PK, Caemaert J. Treatment of cystic craniopharyngioma by endocavitary instillation of yttrium90 radioisotope–still a valuable treatment option. J Neurol Surg Part Cent Eur Neurosurg. 2013;74:307–12.

    Article  Google Scholar 

  • Varlotto JM, Flickinger JC, Kondziolka D, Lunsford LD, Deutsch M. External beam irradiation of craniopharyngiomas: long-term analysis of tumor control and morbidity. Int J Radiat Oncol Biol Phys. 2002;54:492–9.

    Article  PubMed  Google Scholar 

  • Wijnen M, van den Heuvel-Eibrink MM, Janssen JAMJL, Catsman-Berrevoets CE, Michiels EMC, van Veelen-Vincent M-LC, Dallenga AHG, van den Berge JH, van Rij CM, van der Lely A-J, et al. Very long-term sequelae of craniopharyngioma. Eur J Endocrinol. 2017;176:755–67.

    Article  CAS  PubMed  Google Scholar 

  • Winkfield KM, Linsenmeier C, Yock TI, Grant PE, Yeap BY, Butler WE, Tarbell NJ. Surveillance of craniopharyngioma cyst growth in children treated with proton radiotherapy. Int J Radiat Oncol Biol Phys. 2009;73:716–21.

    Article  PubMed  Google Scholar 

  • Yu X, Zhang J, Liu R, Wang Y, Wang H, Wang P, Chen J, Liu S. Interstitial radiotherapy using phosphorus-32 for giant posterior fossa cystic craniopharyngiomas. J Neurosurg Pediatr. 2015;15:510–8.

    Article  PubMed  Google Scholar 

  • Zacharia BE, Bruce SS, Goldstein H, Malone HR, Neugut AI, Bruce JN. Incidence, treatment and survival of patients with craniopharyngioma in the surveillance, epidemiology and end results program. Neuro-Oncology. 2012;14:1070–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhang Y-Q, Wang C-C, Ma Z-Y. Pediatric craniopharyngiomas: clinicomorphological study of 189 cases. Pediatr Neurosurg. 2002;36:80–4.

    Article  PubMed  Google Scholar 

  • Zhang S, Fang Y, Cai BW, Xu JG, You C. Intracystic bleomycin for cystic craniopharyngiomas in children. Cochrane Database Syst Rev. 2016;7:CD008890.

    PubMed  Google Scholar 

  • Zhang C, Verma V, Lyden ER, Horowitz DP, Zacharia BE, Lin C, Connolly EP. The role of definitive radiotherapy in craniopharyngioma: a SEER analysis. Am J Clin Oncol. 2017;0:1–6

    Google Scholar 

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Seidel, C., Meixensberger, J., Kortmann, R.D. (2018). Radiation Therapy in Craniopharyngioma. In: Wenz, F. (eds) Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-52619-5_7-1

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  • DOI: https://doi.org/10.1007/978-3-319-52619-5_7-1

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