Combined proton and photon irradiation for craniopharyngioma: Long-term results of the early cohort of patients treated at Harvard Cyclotron Laboratory and Massachusetts General Hospital

Fitzek, Markus M.; Linggood, Rita M.; Adams, Judy; Munzenrider, John E.

doi:10.1016/j.ijrobp.2005.09.034

Cited by 117 publications

(35 citation statements)

References 25 publications

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“…49 Along the same lines, preliminary experiences with proton-beam therapy applied to craniopharyngioma are promising, offering a less morbid radiooncological option for tumors localized in the vicinity of the optic nerve or chiasm, pituitary gland, or hypothalamus. 8,32,63 Reported long-term consequences after limited craniopharyngioma surgery combined with irradiation include optic neuropathy and brainstem necrosis, but this is not as common in modern radiation therapy series as in more dated publications. There have also been reports of malignant transformation of craniopharyngioma, although this too is a rare event.…”

Section: Discussionmentioning

confidence: 99%

Comparative effectiveness of treatment options for pediatric craniopharyngiomas

Ali

Bailey

Daniels

et al. 2014

PED

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Object No clear treatment guidelines for pediatric craniopharyngiomas exist. The authors developed a decision analytical model to evaluate outcomes of 4 surgical approaches for craniopharyngiomas in children, including attempted gross-total resection (GTR), planned subtotal removal plus radiotherapy, biopsy plus radiotherapy, and endoscopic resections of all kinds. Methods Pooled data, including the authors' own experience, were used to create evidence tables, from which incidence, relative risks, and summary outcomes in quality-adjusted life years (QALYs) were calculated for the 4 management strategies. Results Quality-adjusted life years at the 5-year follow-up were 2.3 ± 0.1 for attempted GTR, 2.9 ± 0.2 for planned subtotal removal plus radiotherapy, 3.9 ± 0.2 for biopsy plus radiotherapy, and 3.7 ± 0.2 for endoscopic resection (F = 17,150, p < 0.001). Similarly, QALYs at 10-year follow-up were 4.5 ± 0.2 for attempted GTR, 5.7 ± 0.5 for planned subtotal removal plus radiotherapy, and 7.8 ± 0.5 for biopsy plus radiotherapy (F = 6,173, p < 0.001). On post hoc pairwise comparisons, the differences between all pairs compared were also highly significant (p < 0.001). Since follow-up data at 10 years are lacking for endoscopic cases, this category was excluded from 10-year comparisons. Conclusions Biopsy with subsequent radiotherapy is the preferred approach with respect to improved overall quality of life. While endoscopic approaches also show promise in preserving quality of life at five-year follow-up, there are not sufficient data to draw conclusions about this comparison at 10 years.

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Section: Discussionmentioning

confidence: 99%

Comparative effectiveness of treatment options for pediatric craniopharyngiomas

Ali

Bailey

Daniels

et al. 2014

PED

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“…In 5 children and 10 adults treated with combined proton-photon rt, Fitzek et al 19 reported actuarial 5-and 10-year local control rates of 93% and 85% respectively.…”

Section: Pediatricsmentioning

confidence: 99%

Recommendations for the Referral of Patients for Proton-Beam Therapy, an Alberta Health Services Report: A Model for Canada?

et al. 2014

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able and willing to travel abroad to a proton facility. Commonly accepted indications for referral include chordoma and chondrosarcoma, intraocular melanoma, and solid tumours in children and adolescents who have the greatest risk for long-term sequelae. Current data do not provide sufficient evidence to recommend routine referral of patients with most head-and-neck, breast, lung, gastrointestinal tract, and pelvic cancers, including prostate cancer. It is recommended that all referrals be considered by a multidisciplinary team to select appropriate cases.

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“…[20][21][22] A study from a proton facility reported 5-and 10-year local control rates of 93% and 85%, respectively, in a group of 5 children and 10 adults. 20 Similar outcomes were reported by Luu et al 21 in a group of 16 patients with acceptable toxicity profiles. Bishop et al 22 compared the records of 52 children treated with proton beam therapy (n = 21) vs photon IMRT (n = 31).…”

Section: Craniopharyngiomasmentioning

confidence: 99%