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Stereotactic radiosurgery for craniopharyngiomas.

Stylianos Pikis1, Georgios Mantziaris2, Karen Lavezzo2

  • 1Department of Neurological Surgery, University of Virginia Health System, Box 800212, Charlottesville, VA, 22908, USA.

Acta Neurochirurgica
|September 14, 2021
PubMed
Summary

Gamma Knife radiosurgery (GKRS) offers a safe and effective treatment for selected craniopharyngioma patients, with long-term survival rates. However, higher radiation doses increase the risk of neurological deficits, necessitating careful parameter selection.

Keywords:
CraniopharyngiomaGamma KnifeRadiosurgery

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Oncology

Background:

  • Craniopharyngiomas present management challenges, often requiring multidisciplinary care.
  • Evaluating long-term outcomes of Gamma Knife radiosurgery (GKRS) for craniopharyngiomas is crucial.

Purpose of the Study:

  • To assess the long-term clinical and radiologic outcomes of GKRS in craniopharyngioma patients.
  • To identify risk factors associated with clinical deterioration after GKRS.

Main Methods:

  • Retrospective analysis of 38 patients treated with GKRS for craniopharyngioma between 1989 and 2019.
  • Analysis of clinical, radiologic, tumor, and procedural data.

Main Results:

  • Overall survival rates at 5 and 10 years were 84.1% and 80.1%, respectively.
  • Progression-free survival at 5 and 10 years was 48.1% and 29.8%.
  • Increased isocenters, margin dose, and maximum dose >35 Gy were risk factors for post-GKRS deterioration.

Conclusions:

  • Stereotactic radiosurgery (SRS) is a viable option for select craniopharyngioma patients.
  • Higher radiation doses (margin and maximum) correlate with increased risk of neurological deficits.
  • Further research is needed to optimize SRS parameters and patient selection for craniopharyngioma treatment.