Visual outcome, endocrine function and tumor control after fractionated stereotactic radiation therapy of craniopharyngiomas in adults: findings in a prospective cohort
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Background: The purpose of this study was to examine visual outcome, endocrine function and tumor control in a prospective cohort of craniopharyngioma patients, treated with fractionated stereotactic radiation therapy (FSRT).Material and methods: Sixteen adult patients with craniopharyngiomas were eligible for analysis. They were treated with linear accelerator-based FSRT during 1999–2015. In all cases, diagnosis was confirmed by histological analysis. The prescription dose to the tumor was 54 Gy (median, range 48–54) in 1.8 or 2.0 Gy per fraction, and the maximum radiation dose to the optic nerves and chiasm was 54.2 Gy (median, range 48.6–60.0) for the cohort. Serial ophthalmological and endocrine evaluations and magnetic resonance imaging (MRI) scans were performed at regular intervals. Median follow-up was 3.3 years (range 1.1–14.1), 3.7 years (range 0.8–15.2), and 3.6 years (range 0.7–13.1) for visual outcome, endocrine function, and tumor control, respectively.Results: Visual acuity impairment was present in 10 patients (62.5%) and visual field defects were present in 12 patients (75%) before FSRT. One patient developed radiation-induced optic neuropathy at seven years after FSRT. Thirteen of 16 patients (81.3%) had pituitary deficiency before FSRT, and did not develop further pituitary deficiency after FSRT. Mean tumor volume pre-FSRT was 2.72 cm3 (range 0.20–9.90) and post-FSRT 1.2 cm3 (range 0.00–13.10). Tumor control rate was 81.3% at two, five, and 10 years after FSRT.Conclusions: FSRT was relatively safe in this prospective cohort of craniopharyngiomas, with only one case of radiation-induced optic neuropathy and no case of new endocrinopathy. Tumor control rate was acceptable.
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Radiation-induced hypopituitarism does not commence until 2 years or more after irradiation, continuing probably for more than 10 years.
“Response to direct or indirect irradiation of the hypothalamic-pituitary region is insidious and radiation-induced hypopituitarism does not commence until 2 years or more after the irradiation, continuing probably for more than 10 years (Astradsson et al., 2017;Roug et al., 2010).”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Astradsson et al., 2017
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Self-citation
- Authors
- Astradsson, A., Munck af Rosenschöld, P., Feldt-Rasmussen, U., Poulsgaard, L., Wiencke, A. K., Ohlhues, L., Engelholm, S. A., Broholm, H., Hansen Møller, E., Klose, M., Roed, H., & Juhler, M.
- Affiliations
- Hvidovre Hospital (DK)
- Department of Radiation Oncology, Finsen Center, Rigshospitalet, Copenhagen, Denmark;
- Department of Medical Endocrinology, Rigshospitalet, Copenhagen, Denmark;
- Rigshospitalet (DK)
- Glostrup Hospital (DK)
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark;
- Corresponding author
- Astradsson, Arnar
- Venue
- Acta Oncologica
- Published
- 2017-01-13
- Volume
- 56
- Issue
- 3
- Pages
- 415-421
- ISSN
- 0284-186X (ISSN-L)
- 1651-226X
- OpenAlex
- W2576447746
- Cited by
- 26
- References
- 29
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 2 · 2022: 7 · 2021: 2 · 2020: 5 · 2019: 4 · 2018: 2
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Acta Oncologica (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Hetland Olsens foundation
- Sophus and Astrid Jacobsens foundation
- Neuroscience Center
- Clinics of Neurosurgery and Traumatic Brain Injury and Neurorehabilitation
- Rigshospitalet University Hospital
- Region Hovedstaden (Capital Region Research Grant for Health Research)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Health Sciences › Medicine › Epidemiology › Meningioma and schwannoma management
- Keywords
- craniopharyngioma, fractionated stereotactic radiotherapy, visual outcome, visual acuity loss, visual field defects, radiation-induced optic neuropathy, pituitary function, endocrine function, tumor control, adult patients
- MeSH terms
- Adolescent, Adult, Aged, Craniopharyngioma, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pituitary Gland, Pituitary Hormones, Pituitary Neoplasms, Radiotherapy Dosage, Retrospective Studies, Vision, Ocular, Radiosurgery, Treatment Outcome, Dose Fractionation, Radiation, Tumor Burden, Young Adult
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