Intratumoral therapy with bleomycin for cystic craniopharyngiomas in children

Surgical removal of cystic craniopharyngiomas in children is associated wit h significant operative morbidity and recurrence rates. The purpose of this study was to review our experience with a less invasive therapy, namely, i ntratumoral bleomycin, in the treatment of predominantly cystic craniophary ngiomas. All children with craniopharyngiomas treated at a tertiary care pe diatric neurosurgical center since 1994, when bleomycin was first used, wer e reviewed retrospectively. Seven patients received intratumoral bleomycin therapy. Patients received 2-5 mg bleomycin per dose, 3 times per week, for 3-5 weeks as an initial course. Mean follow-up of these patients was 3 yea rs. In 4 patients, treatment resulted in a significant decrease (>50%) in t umor size, which has remained stable. Two patients' tumors progressed and u nderwent resection, and 1 patient had surgical removal because of persisten t headaches, although no growth of residual tumor had been noted. One patie nt developed peritumoral edema as a result of bleomycin therapy. Intratumor al bleomycin is a usefu I alternative therapy for cystic craniopharyngiomas , and may control tumor growth and delay potentially harmful resection and/ or radiotherapy in young children. Copyright (C) 2000 S. Karger AG, Basel.