Visual outcome, endocrine function and tumor control after fractionated stereotactic radiation therapy of craniopharyngiomas in adults: findings in a prospective cohort

Figures & data

Table 1. Patients, tumor characteristics and surgical treatment.

Total	16
Females	7 (43.75%)
Males	9 (56.25%)
Mean age (years)	52 (range 17–71)
Tumor volume (mean)	2.72 cm^3 (range 0.20–9.90)
Tumor localization
Intrasellar	7 (43.8%)
Suprasellar	5 (31.2%)
Intra- and suprasellar	4 (25.0%)
Tumor composition
Solid	9 (66.3%)
Mixed, cystic and solid	6 (37.5%)
Cystic	1 (6.3%)
Operation prior to FSRT
Total	16 (100%)
One/two/three/four operations	6/8/1/1
Months from last operation until FSRT (median)	20.5 (range 5–118)
Reoperation after FSRT
Total/one operation	3 (18.8%)
Months from FSRT until reoperation (median)	10.7/11.8/13.7

Figure 1. Example dose plan in iPlan (BrainLab) for IMRT of a craniopharyngioma, with coronal, axial and sagittal CT overlaid on MRI with gadolinium (Gd) enhancement. The target volume was defined and treated without setup margins. The eye balls, optic chiasm, nerves and tracts, and brainstem were outlined and defined as organs at risk. The prescription dose of 54 Gy was prescribed to the 90% isodose contour, and the 90% isodose contour was encompassing the target volume.

Table 2. Visual function after FSRT.

Baseline	Improved	Unchanged	Worsened
Visual acuity intact	–	6	0
Visual acuity impaired	1	7	2
Visual fields intact	–	4	0
Visual fields impaired	1	11	0

Table 3. Pituitary hormone deficiency.

	Before FSRT	After FSRT
None	3	3
2 axes (TSH/ACTH)	2	2
3 axes (TSH/GH/ACTH)	1	1
3 axes (TSH/ACTH/FSH + LH)	1	1
4 axes (TSH/GH/ACTH/FSH + LH)	9	9^a

ACTH: Adrenocorticotropic hormone; FSH/LH: gonadotropins; GH: growth hormone; TSH: thyroid stimulating hormone.

^a One of these patients elected not to receive growth hormone substitution after FSRT.

Figure 2. Actuarial tumor control rates at 2, 5 and 10 years after FSRT were 81.3%. Shaded areas represent the 95% confidence intervals.