CRANIOPHARYNGIOMA - TREATMENT IN THE CT AND MR-IMAGING ERA

PURPOSE: To determine optimal treatment in patients with craniopharyng iomas. MATERIALS AND METHODS: In 1977-1990, 49 patients (age range, 3- 67 years; median age, 35 years; 25 female, 24 male) with craniopharyng iomas were examined. Follow-up was 5-17 years (median, 8 years). Fifte en patients were aged younger than 18 years. RESULTS: All patients und erwent surgical resection. Complete resection was achieved in 19. Seve n patients underwent additional surgery for recurrent disease. Rate of mortality due to surgical complications was 10% (n = 5). Eight patien ts had marked perioperative or long-term morbidity. Twenty-five patien ts judged to have undergone subtotal resection underwent postoperative radiation therapy (RT). RT doses were 4,600-6,287 cGy administered in fractions of 180-200-cGy/d. Actuarial 5-year progression-free surviva l in patients who underwent complete resection was 63% (12 of 19 patie nts) versus 96% (24 of 25 patients) in patients who underwent subtotal resection followed by RT (P = .04). No RT dose response was observed. Patient functional status has not been substantially affected by adju vant RT. CONCLUSION: RT achieves excellent tumor control after subtota l resection of craniopharyngiomas.