Stereotactic radiosurgery of residual or recurrent craniopharyngioma, after surgery, with or without radiation therapy

This study evaluated the role of stereotactic radiosurgery in the multimoda lity management of craniopharyngioma patients whose prior therapies failed. Ten consecutive patients (3 males and 7 females) had radiosurgery for cran iopharyngioma during a 10-year interval. Their ages ranged from 9 to 64 yea rs (median, 14.5 years). The median interval between diagnosis and radiosur gery was 46.5 months. In total, 12 stereotactic radiosurgical procedures we re performed to control the solid component of the tumor (2 intrasellar and 10 suprasellar tumors). The median tumor volume was 1.35 cm(3). One to 9 i socenters with different beam diameters were used; the median marginal dose was 16.4 Gy; and the dose to the optic apparatus was limited to less than 8 Gy, Clinical and imaging follow-up data were obtained at a median of 63 m onths (range, 13-150 months) from radiosurgery, Overall, 7 of 12 tumors bec ame smaller or vanished within a median of 8.5 months. Prior visual defects objectively improved in 6 patients. One patient with prior visual defect d eteriorated further and lost vision 9 months after radiosurgery, Multimodal ity therapy is often necessary for patients with refractory solid and cysti c craniopharyngiomas, Stereotactic radiosurgery is a reasonable option in s elect patients with small recurrent or residual craniopharyngioma.