Radical surgery, despite its severe side effects, has been always considered by many neurosurgeons the gold standard of treatment of childhood craniopharyngioma. With the aim of reducing the side effects of the classical therapeutic approach, it is becoming more and more popular a treatment strategy based on debulking surgery or cyst drainage followed by local radiotherapy. In this case conformational or stereotactic radiotherapy techniques are recommended to assure an adequate treatment of the target volume and at the same time a significant spare of the healthy adjacent brain parenchyma. The location of the tumour close to the chiasma and the hypothalamus limited the use of radiosurgery to very selected cases, thus stereotactic fractionated radiotherapy represents the technique of choice. From June 1998 to August 1999, six children affected by craniopharyngioma have been treated with this technique, 5 after non-radical surgery and 1 at the time of tumour relapse. All have received 54 Gy in 27 fractions without reporting significant side effects; none of them received steroids. At the last follow-up all patients are alive with stable disease. Only one child suffers of sever obesity, which was present before the radiotherapic treatment. None of them had visual deterioration. The short follow-up of this small series of children does not allow to reach any firm conclusion; however the distribution of the radiotherapeutic dose administered allows to hope in the same tumour control rate than historically achieved with more aggressive treatment, but hopefully with less severe vascular and psychocognitive effects.
|Translated title of the contribution||Stereotactic fractionated radiotherapy in childhood craniopharyngioma. Experience of radiotherapy of Padova|
|Number of pages||4|
|Publication status||Published - 2001|
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