Cystic craniopharyngioma: intratumoral chemotherapy with alpha interferon

Dastoli, Patricia Alessandra; Nicácio, Jardel Mendonça; Silva, Nasjla Saba; Capellano, Andrea Maria; Toledo, Sílvia Regina Caminada de; Ierardi, Daniela F; Cavalheiro, Sérgio

doi:10.1590/s0004-282x2011000100011

Cited by 37 publications

(22 citation statements)

References 23 publications

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“…[155][156][157][158] Intracavitary interferon-α, which is thought to restrict cyst growth by inducing Fas-mediated apoptosis, was trialed by Cavalheiro et al in a small study of 21 children, all of whom had at least a 60% reduction in net cyst volume. [159][160][161][162] In their report, 11 patients demonstrated greater than 90% volume reduction, 7 had 70% to 90% reduction, 3 had less than 70% reduction, and 2 progressed despite treatment. Side effects were minimal, with new endocrinopathies observed in only 15%, and another 30% developing minor complications such as weight loss, poor oral intake, fatigue, and behavioral abnormalities.…”

Section: Overview Of Radiotherapymentioning

confidence: 94%

Pediatric Craniopharyngiomas: A Primer for the Skull Base Surgeon

et al. 2018

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Pediatric craniopharyngioma is a rare sellar-region epithelial tumor that, in spite of its typically benign pathology, has the potential to be clinically devastating, and presents a host of formidable management challenges for the skull base surgeon. Strategies in craniopharyngioma care have been the cause of considerable controversy, with respect to both philosophical and technical issues. Key questions remain unresolved, and include optimizing extent-of-resection goals; the ideal radiation modality and its role as an alternative, adjuvant, or salvage treatment; appropriate indications for expanded endoscopic endonasal surgery as an alternative to transcranial microsurgery; risks and benefits of skull base techniques in a pediatric population; benefits of and indications for intracavitary therapies; and the preferred management of common treatment complications. Correspondingly, we sought to review the preceding basic science and clinical outcomes literature on pediatric craniopharyngioma, so as to synthesize overarching recommendations, highlight major points of evidence and their conflicts, and assemble a general algorithm for skull base surgeons to use in tailoring treatment plans to the individual patient, tumor, and clinical course. In general terms, we concluded that safe, maximal, hypothalamic-sparing resection provides very good tumor control while minimizing severe deficits. Endoscopic endonasal, intraventricular, and transcranial skull base technique all have clear roles in the armamentarium, alongside standard craniotomies; these roles frequently overlap, and may be further optimized by using the approaches in adaptive combinations. Where aggressive subtotal resection is achieved, patients should be closely followed, with radiation initiated at the time of progression or recurrence-ideally via proton beam therapy, although three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and stereotactic radiosurgery are very appropriate in a range of circumstances, governed by access, patient age, disease architecture, and character of the recurrence. Perhaps most importantly, outcomes appear to be optimized by consolidated, multidisciplinary care. As such, we recommend treatment in highly experienced centers wherever possible, and emphasize the importance of longitudinal follow-up-particularly given the high incidence of recurrences and complications in a benign disease that effects a young patient population at risk of severe morbidity from hypothalamic or pituitary injury in childhood.

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Section: Overview Of Radiotherapymentioning

confidence: 94%

Pediatric Craniopharyngiomas: A Primer for the Skull Base Surgeon

et al. 2018

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“…Cystic CPs are considered those in which the cystic portion predominantly accounted for at least 60% of the tumors. This diagnosis was made using MRI [19].…”

Section: Neuroradiological Evaluationmentioning

confidence: 99%

Pediatric symptomatic Rathke cleft cyst compared with cystic craniopharyngioma

et al. 2016

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“…Ommaya reservoirs have also been placed into the cysts of craniopharyngiomas in order to deliver chemotherapy agents intratumorally. The two agents that have previously been successfully utilized using this method of drug delivery are bleomycin and alpha interferon [51,52].…”

Section: Intra-ommaya Therapymentioning

confidence: 99%

Pediatric Neuro-Oncology in Low-/Middle-Income Countries

Zaghloul¹

2016

Neurooncology - Newer Developments

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Pediatric cancer is becoming increasingly important in low-/middle-income countries (LMICs), due to the improvement in controlling communicable diseases, decrease infant, and early childhood mortalities associated with infection and malnutrition.Worldwide, although much improvement was encountered in many pediatric tumors particularly acute leukemia that represents the commonest type of cancer in children, this was not so obvious in CNS tumors, the second most common tumor type. Slow advances have been achieved to improve treatment end results in pediatric neuro-oncology. This was largely related to disease under diagnosis, incorrect clinical assessment, improper staging, and lack of the availability of appropriate radiologic, neurosurgical, and radiotherapeutic services in LMICs. Moreover, the need for multidisciplinary team working together to embalmment unified approved management guidelines, highly specific care level within a widely accepted quality control measures are of utmost importance to raise the treatment outcome levels to that of high-income countries (HICs).Much effort is needed in LMICs to improve the management of pediatric CNS tumors, decrease the gap, and reach good results already attained by the dedicated centers in HICs. There are many international organizations and societies that can and are willing to help in this matter.In this chapter, an illustration of the obstacles faced by LMIC neuro-oncologists will be discussed. The different ways and procedures are recommended to improve the general situation to attain good results similar to that in HICs.

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Cystic craniopharyngioma: intratumoral chemotherapy with alpha interferon

Cited by 37 publications

References 23 publications

Pediatric Craniopharyngiomas: A Primer for the Skull Base Surgeon

Pediatric Craniopharyngiomas: A Primer for the Skull Base Surgeon

Pediatric symptomatic Rathke cleft cyst compared with cystic craniopharyngioma

Pediatric Neuro-Oncology in Low-/Middle-Income Countries

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