Early adjuvant radiotherapy toward long-term survival and better quality of life for craniopharyngiomas--a study in single institute

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Moon, Sung Ho; Kim, Il Han; Park, Seok Won; Kim, Inah; Hong, Semie; Park, Charn Il; Wang, Kyu Chang; Cho, Byung Kyu
Issue Date
Childs Nerv Syst. 2005 Aug;21(8-9):799-807. Epub 2005 Jun 14.
AdolescentAdultChildChild, PreschoolCraniopharyngioma/pathology/*radiotherapyDisease ProgressionDisease-Free SurvivalFemaleFollow-Up StudiesHumansImaging, Three-DimensionalInfantMaleMiddle AgedPituitary Neoplasms/pathology/*radiotherapyPostoperative Complications*Quality of LifeRadiosurgeryRadiotherapy DosageRadiotherapy, Adjuvant/methodsRetrospective StudiesTime FactorsTreatment OutcomeVision Disorders/etiology
OBJECTIVES: The objective of the study is to compare survival and quality of life (QoL) by the delivery time of adjuvant radiotherapy (RT), early or late, for craniopharyngiomas. METHODS AND MATERIALS: Fifty patients received RT between 1985 and 2002. Early RT (n=25) was delivered within 3 months after initial surgery, whereas late RT (n=25) was combined with or without reoperation after progression or relapse. Radiation dose ranged from 45 to 55.8 Gy with a median of 54 Gy. The median follow-up was 130 months. RESULTS: Progression-free survival rates at 5 and 10 years were 95.9 and 91.2%, respectively. The overall or progression-free survival was not influenced by RT time. Initial tumor size was the only prognostic factor (p=0.034) for progression-free survival in univariate analysis. Better visual acuity or field was maintained, and diabetes insipidus was partly improved with early RT, but all were deteriorated as tumor progressed without early RT. Visual functions were not worsened after late RT. CONCLUSIONS: The survival was excellent with adjuvant RT, early or late. Poor QoL with late RT resulted from relapsed tumor and repeated surgery but was not associated with RT itself. Thus, early RT with precision technique is highly recommended for better QoL and excellent survival, unless contraindicated.
0256-7040 (Print)
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College of Medicine/School of Medicine (의과대학/대학원)Neurosurgery (신경외과학전공)Journal Papers (저널논문_신경외과학전공)
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