STEREOTAXIC INTRATUMOR IRRADIATION WITH NUCLIDE FOR CRANIOPHARYNGIOMAS

Objective. Craniopharygiomas is a kind of intractable tumor in neurosu rgery. Since the radical excision is very difficult and occasionally-h azardous because of its deep location and close neighbouring to critic al cerebral structures, it is necessary to look for a simple and effec tive method. Patients and Methods.' Stereotactic intratumour irradiati on with instillation of nuclide colloid was performed in 220 patients with craniopharyngiomas (altogether 265 times), of whom, 130 were male and 90 female. Their ages ranged from 5 to 69 years. The syndromes of optic path's impairment were present in all of the patients. CT or MR I scan showed cystic tumour in 125 patients, solid and Cystic in 80 an d solid in 15. No severe complications and death were related to the o peration. Results. 150 patients were followed up for 2 months to 7 yea rs (average 3.5 years). Tumours disappeared in 92 patients (61.4%), de creased dramatically in 20 (13.4%), decreased less than 50% in 19 (12. 6%), and increased in 15 (10%), and there were 4 deaths (2.6%). Conclu sions, Stereotactic intratumour irradiation with instillation of nucli de colloid is effective in the patients with craniopharygiomas. Beta-e mitting isotopes (P-32 and Y-90) are the preferred internal radiation source because of their limited penetration of the energy released and the greater ease of handling. A calculated dose of 20 000 rads to the cyst wall is recommended.