Purpose: To present first case of refractory craniopharyngioma treated successfully with SRS in Nepal.Background: Craniopharyngioma is a benign tumour, which progresses slowly and compresses the pituitary gland and nearby structures. First line of treatment is surgery followed by adjuvant radiotherapy as complete resection is usually not feasible. Here, we are reporting a case of recurrent craniopharyngioma treated with LINAC based SRS.Case Presentation: A 43 years old man diagnosed case of craniopharyngioma in May 2019. He underwent left pterional craniotomy and subtotal resection of tumour and kept on observation. He developed symptomatic as well as radiological recurrence in July 2020. Second debulking was not possible, so we did SRS on 23rd August 2020; 14Gy Dose was delivered to gross tumour volume. Six months after SRS, Patient is doing well.Conclusions: LINAC based SRS is a frameless, non-invasive and safe procedure with excellent clinical outcomes for recurrent or residual craniopharyngioma.
In Nepal, the incidence of cancer in both males and females increased drastically in the last decade and is predicted to increase as well in the near future. The increase in Cancer burden could be a serious concern due to an underdeveloped national cancer control program. Around 50-60% of cancer patients require radiotherapy at some point during their illness which establishes it as an integral component of comprehensive cancer care. The current status of radiation facilities in the country is so scarce that it will be impossible to address the issue with available resources. It is high time for the authority to formulate a national cancer control program including the development of radiotherapy equipment and human resources. This article discusses the number of radiotherapy facilities, available equipment, and trained manpower in Nepal. Whether the available facilities are as per standard recommendation and will those be enough to handle the increasing load of cancer patients requiring radiotherapy in the future has been emphasized. Along with those challenges, the opportunities for developing radiotherapy facilities in Low Middle-Income countries like Nepal have been stressed out.
The majority of cancer patients will require radiotherapy at some time during their illness, either for curative or palliative purposes, making it an important part of a multidisciplinary cancer treatment approach. External beam radiotherapy and brachytherapy are two methods of administering radiation to the tumor location. Cobalt tele source, Linear accelerator, and Tomotherapy are examples of external beam radiotherapy equipment; similarly, after loading brachytherapy unit is an example of brachytherapy equipment. Because these units generate radiation, a specific site design is required to guarantee that radiation leakage is kept to a minimum. Linear accelerator and Brachytherapy devices are housed in specialized chambers known as “Bunkers.” The engineering of these bunkers is still a difficulty. The layout of the radiation department is designed in such a way that it will smooth the day-to-day operations and maximize the efficiency of the working crew. The general considerations, location, and layout of different rooms built for the LINAC and brachytherapy unit at CMC, Bharatpur, Nepal are discussed in this study.
Purpose: To present first case of refractory craniopharyngioma treated successfully with SRS in Nepal. Background: Craniopharyngioma is a benign tumor, which progresses slowly and compresses the pituitary gland and nearby structures. First line of treatment is surgery followed by adjuvant radiotherapy as complete resection is usually not feasible. Here, we are reporting a case of recurrent craniopharyngioma treated with LINAC based SRS. Case Presentation: A 43 years old man diagnosed case of craniopharyngioma in May 2019. He underwent left pterional craniotomy and subtotal resection of tumor and kept on observation. He developed symptomatic as well as radiological recurrence in July 2020. Second debulking was not possible, so we did SRS on 23rd August 2020; 14Gy Dose was delivered to gross tumor volume. Six months after SRS, Patient is doing well.Conclusions: LINAC based SRS is a frameless, non-invasive and safe procedure with excellent clinical outcomes for recurrent or residual craniopharyngioma.
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