Long-term outcomes of neuroendoscopic cyst partial resection combined with stereotactic radiotherapy for craniopharyngioma.

Autor: Fukuhara N; Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Minato-Ku, Tokyo, Japan. n-fukuhara@hotmail.co.jp.; Okinaka Memorial Institute for Medical Research, Minato-Ku, Tokyo, Japan. n-fukuhara@hotmail.co.jp., Nishihara T; Internal medicine and neurosurgery Nishihara clinic, Adachi-Ku, Tokyo, Japan., Sato K; CyberKnife Center, Okayama Kyokuto Hospital, Okayama, Japan., Inoshita N; Okinaka Memorial Institute for Medical Research, Minato-Ku, Tokyo, Japan.; Department of Pathology, Moriyama Memorial Hospital, Edogawa-Ku, Tokyo, Japan.; Department of Pathology, Toranomon Hospital, Minato-Ku, Tokyo, Japan., Tatsushima K; Department of Endocrinology and Metabolism, Toranomon Hospital, Minato-Ku, Tokyo, Japan., Yamaguchi-Okada M; Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Minato-Ku, Tokyo, Japan., Ishojima T; Okinaka Memorial Institute for Medical Research, Minato-Ku, Tokyo, Japan.; Department of Pediatrics, Toranomon Hospital, Minato-Ku, Tokyo, Japan., Takeshita A; Okinaka Memorial Institute for Medical Research, Minato-Ku, Tokyo, Japan.; Department of Endocrinology and Metabolism, Toranomon Hospital, Minato-Ku, Tokyo, Japan., Ito J; Department of Pediatrics, Toranomon Hospital, Minato-Ku, Tokyo, Japan., Takeuchi Y; Okinaka Memorial Institute for Medical Research, Minato-Ku, Tokyo, Japan.; Department of Endocrinology and Metabolism, Toranomon Hospital, Minato-Ku, Tokyo, Japan., Yamada S; Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Minato-Ku, Tokyo, Japan.; Okinaka Memorial Institute for Medical Research, Minato-Ku, Tokyo, Japan.; Hypothalamic and Pituitary Center, Moriyama Memorial Hospital, Edogawa-Ku, Tokyo, Japan., Nishioka H; Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Minato-Ku, Tokyo, Japan.; Okinaka Memorial Institute for Medical Research, Minato-Ku, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Acta neurochirurgica [Acta Neurochir (Wien)] 2024 May 15; Vol. 166 (1), pp. 218. Date of Electronic Publication: 2024 May 15.
DOI: 10.1007/s00701-024-06113-y
Abstrakt: Purpose: The aim of this study was to evaluate the treatment outcomes of neuroendoscopic cyst partial resection (ECPR) combined with stereotactic radiotherapy (SRT) for cystic craniopharyngiomas.
Methods: In this retrospective study, 22 craniopharyngioma patients undergoing ECPR combined with SRT were included. This combination therapy was indicated for suprasellar cystic craniopharyngiomas in patients whose pituitary function was preserved but would be difficult to preserve in direct surgery. The outcomes of combination therapy, including tumor control and postoperative visual and pituitary functions, were investigated.
Results: ECPR was safely performed, and cyst shrinkage was accomplished in all cases. After ECPR, visual function improved in 12 of 13 patients (92%) with visual field disturbance and did not deteriorate in any patients. Pituitary function was preserved in 14 patients (64%) and deteriorated in eight patients (36%) after ECPR. As a complication of ECPR, meningitis occurred because of a wound infection in one patient. In 18 of 22 patients (82%), the tumor was controlled without further treatment 19 - 87 months (median, 33 months) after SRT. Hypopituitarism was an adverse event after SRT in two of the 18 patients who achieved tumor control. Four patients (18%) had enlarged cysts after SRT. Postoperative pituitary function was significantly more likely to deteriorate in cases of extensive detachment from the ventricular wall, and retreatment was significantly more common in cases with hypothalamic extension.
Conclusion: Although limited to some cases, ECPR combined with SRT is a less invasive and useful therapeutic option for suprasellar cystic craniopharyngiomas. However, its long-term prognosis requires further evaluation.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)
Databáze: MEDLINE
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