gms | German Medical Science

To investigate the efficacy and toxicity after stereotactic intracavitary irradiation for patients with cystic craniopharyngiomas. Data was assessed with regard to patient survival, tumour control, and visual and endocrinological function before and after treatment.

Between 1986 and 2004, fifty-three treatments with intracavitary irradiation using either 32P or 90Y had been evaluated (total of 48). Median age was 28 (range 5-75) Among these, 27 had had no prior treatment as the primary treatment, and 21 were treated for residual or recurrent tumour cysts. At the time of 32P intracavitary irradiation, 29 of the patients were adults, and 19 were children younger than 18 years of age. The mean cyst volume was 6.2 ml. The radiation dose was 250 Gy to the cyst wall. The mean follow-up periods were 48 months after 32P treatment.

The actuarial survival rates were 92% at 5 years after the diagnosis and 82% at 10 years. The actuarial tumour cyst control rates were 78% at 12 months and 72% at 5 years after the diagnosis. 7 Patients underwent second puncture of the treated cyst, three patients because of leakage. After treatment, 2 patients who underwent preoperative and postoperative visual testing were found to have delayed worsening in visual function attributed to intracavitary irradiation. 12 patients had improved visual function. Only 1 patient who had normal preoperative pituitary function suffered endocrinological deterioration (Diabetes insipidus) No perioperative complications occurred in these patients.

For patients with cystic craniopharyngiomas, 32P intracavitary irradiation proved effective, with a low risk of complications, for the control of tumour cysts but not of solid tumour components.