Paediatric craniopharyngiomas – Treatment outcomes based on when radiotherapy was given
Introduction: Craniopharyngioma is a rare tumour arising in the suprasellar region with benign histology, but high morbidity and recurrence rate. Radiotherapy has been previously shown to reduce risk of local recurrence, but has its own inherent risk. The objective of this paper is to illustrate the...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Interdisciplinary Neurosurgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751922000883 |
| _version_ | 1811336133961842688 |
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| author | Elena How Liam Maclachlan Robert Campbell |
| author_facet | Elena How Liam Maclachlan Robert Campbell |
| author_sort | Elena How |
| collection | DOAJ |
| description | Introduction: Craniopharyngioma is a rare tumour arising in the suprasellar region with benign histology, but high morbidity and recurrence rate. Radiotherapy has been previously shown to reduce risk of local recurrence, but has its own inherent risk. The objective of this paper is to illustrate the management and progression of this disease in a population where radiotherapy was not usually offered as adjuvant to initial surgery. The two aims were to: (1) describe the population and treatment outcomes, and (2) conduct a subgroup analysis of patients based on radiotherapy status in the treatment received. Methods: Available records of patients who were histologically diagnosed with craniopharyngioma below the age of 17 were reviewed. Attributes of interest includes types of surgeries and timing of radiotherapy as well as BMI, hypothalamic function, pituitary function, and vision at diagnosis, during treatment and at long-term follow-up. Results: We identified 25 patients with a mean age of 100.20 ± 53.34 months at diagnosis. Subsequent intervention-free survival is similar between patients who had gross total resection (GTR) and patients who had adjuvant radiotherapy after primary surgery. There was no significant difference in BMI Z-score changes between patients who had different treatment regime nor the number of surgeries they had. In patients who had delayed radiotherapy, there was an increasing incidence of diabetes insipidus and pituitary dysfunction from after primary surgery to last follow-up, but this was not observed in the other groups. Conclusion: In our cohort, subsequent-intervention-free survival was similar between patients who had GTR and patients who had adjuvant radiotherapy after primary surgery. These patients who received delayed radiotherapy had similar outcomes to those who underwent GTR and those who had early radiotherapy. |
| first_indexed | 2024-04-13T17:34:03Z |
| format | Article |
| id | doaj.art-459f6c073e7c401885ba181dd1bc9650 |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-04-13T17:34:03Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-459f6c073e7c401885ba181dd1bc96502022-12-22T02:37:26ZengElsevierInterdisciplinary Neurosurgery2214-75192022-09-0129101574Paediatric craniopharyngiomas – Treatment outcomes based on when radiotherapy was givenElena How0Liam Maclachlan1Robert Campbell2Department of Neurosurgery, Queensland Children Hospital, Brisbane, Australia; Corresponding author at: Department of Neurosurgery, Queensland Children’s Hospital, 501 Stanley St, South Brisbane, QLD 4101, Australia.The Kenneth G Jamieson, Department of Neurosurgery, Royal Brisbane and Women’s Hospital, Brisbane, Australia; The School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, AustraliaDepartment of Neurosurgery, Queensland Children Hospital, Brisbane, AustraliaIntroduction: Craniopharyngioma is a rare tumour arising in the suprasellar region with benign histology, but high morbidity and recurrence rate. Radiotherapy has been previously shown to reduce risk of local recurrence, but has its own inherent risk. The objective of this paper is to illustrate the management and progression of this disease in a population where radiotherapy was not usually offered as adjuvant to initial surgery. The two aims were to: (1) describe the population and treatment outcomes, and (2) conduct a subgroup analysis of patients based on radiotherapy status in the treatment received. Methods: Available records of patients who were histologically diagnosed with craniopharyngioma below the age of 17 were reviewed. Attributes of interest includes types of surgeries and timing of radiotherapy as well as BMI, hypothalamic function, pituitary function, and vision at diagnosis, during treatment and at long-term follow-up. Results: We identified 25 patients with a mean age of 100.20 ± 53.34 months at diagnosis. Subsequent intervention-free survival is similar between patients who had gross total resection (GTR) and patients who had adjuvant radiotherapy after primary surgery. There was no significant difference in BMI Z-score changes between patients who had different treatment regime nor the number of surgeries they had. In patients who had delayed radiotherapy, there was an increasing incidence of diabetes insipidus and pituitary dysfunction from after primary surgery to last follow-up, but this was not observed in the other groups. Conclusion: In our cohort, subsequent-intervention-free survival was similar between patients who had GTR and patients who had adjuvant radiotherapy after primary surgery. These patients who received delayed radiotherapy had similar outcomes to those who underwent GTR and those who had early radiotherapy.http://www.sciencedirect.com/science/article/pii/S2214751922000883Suprasellar tumourHypothalamus dysfunctionBMIRadiotherapyHypothalamic obesityPituitary dysfunction |
| spellingShingle | Elena How Liam Maclachlan Robert Campbell Paediatric craniopharyngiomas – Treatment outcomes based on when radiotherapy was given Interdisciplinary Neurosurgery Suprasellar tumour Hypothalamus dysfunction BMI Radiotherapy Hypothalamic obesity Pituitary dysfunction |
| title | Paediatric craniopharyngiomas – Treatment outcomes based on when radiotherapy was given |
| title_full | Paediatric craniopharyngiomas – Treatment outcomes based on when radiotherapy was given |
| title_fullStr | Paediatric craniopharyngiomas – Treatment outcomes based on when radiotherapy was given |
| title_full_unstemmed | Paediatric craniopharyngiomas – Treatment outcomes based on when radiotherapy was given |
| title_short | Paediatric craniopharyngiomas – Treatment outcomes based on when radiotherapy was given |
| title_sort | paediatric craniopharyngiomas treatment outcomes based on when radiotherapy was given |
| topic | Suprasellar tumour Hypothalamus dysfunction BMI Radiotherapy Hypothalamic obesity Pituitary dysfunction |
| url | http://www.sciencedirect.com/science/article/pii/S2214751922000883 |
| work_keys_str_mv | AT elenahow paediatriccraniopharyngiomastreatmentoutcomesbasedonwhenradiotherapywasgiven AT liammaclachlan paediatriccraniopharyngiomastreatmentoutcomesbasedonwhenradiotherapywasgiven AT robertcampbell paediatriccraniopharyngiomastreatmentoutcomesbasedonwhenradiotherapywasgiven |