Intracystic chemotherapy with bleomycin in the treatment of craniopharyngiomas

Mottolèse, C.; Stan, Horaţiu; Hermier, M.; Berlier, P.; Convert, J.; Frappaz, Didier; Lapras, C

doi:10.1007/s00381-001-0524-5

Cited by 76 publications

(39 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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

View full text Add to dashboard Cite

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.

show abstract

Section: Intra-ommaya Therapymentioning

confidence: 99%

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

Zaghloul¹

2016

Neurooncology - Newer Developments

View full text Add to dashboard Cite

show abstract

“…[24] Cysts can also be controlled by instillation of the cyst with radioactive colloids or chemotherapeutic agents such as bleomycin and IFN. [28][29][30][31][32][33] Other techniques to deliver localized radiation to the craniopharyngioma while minimizing the damage to surrounding vital structures include stereotactic radiotherapy (SRT), stereotactic radiosurgery (SRS) and gamma knife radiosurgery. [34] Sainte-Rose et al, based on their finding that quality-of-life was most severely affected when radical surgery was attempted in children having a pre-operative MRI showing invasion of the hypothalamus by the craniopharyngioma (Type 2), recommended conservative surgery preserving the hypothalamic region followed by RT in such patients.…”

Section: Role Of Conservative Managementmentioning

confidence: 99%

Management of craniopharyngiomas: Role of conservative strategies

Pillai¹

2013

IJNS

View full text Add to dashboard Cite

Craniopharyngiomas are uncommon tumors and their management remains controversial. Despite gross total resection, recurrences can occur in 15-43% during long-term follow-up of more than 10 years. Furthermore, radical surgery can be associated with complications associated with hypothalamic damage, which can lead to a poor quality-of-life. Limited surgery followed by adjuvant radiotherapy (RT) can provide excellent long-term tumor control with minimum complications and good functional outcome. RT can however, produce insidious onset of hypopituitarism and vasculopathy. Secondary malignancies are a rare complication of RT. Modern radiation techniques and intracystic radiation can reduce these complications. Intracystic radiation is highly effective for cystic craniopharyngiomas. Intracystic bleomycin (ICB) and interferon alpha (IFN) are rarely curative, but can produce long lasting control of tumor cysts and this is very useful in very young children who may not tolerate radical surgery or RT. IFN has fewer toxicity issues compared to ICB.

show abstract

“…Subsequently, there have been a number of single-center case series 5,14,16,22,25,27,33,35 and case reports 1,3,9,17,26,41,42 published on the use of intracystic bleomycin for craniopharyngioma, both as de novo treatment and as treatment for recurrences. In addition, the experience of intratumoral bleomycin use across multiple centers in Canada has been reviewed.…”

Section: Intracystic Bleomycinmentioning

confidence: 99%

“…19 At a mean follow-up of 2 to 7 years (the range of means for the studies), 43 to 70% of patients required no treatment in addition to bleomycin, 5,16,19,33,43 but there is no information about the durability of the bleomycin effect at 10 years or longer. In the Canadian experience, 19 which is similar to the other reported series, 94% responded to intracystic bleomycin, but the duration of response was < 1 year in 47%.…”

Section: Intracystic Bleomycinmentioning

confidence: 99%

“…In a review of the complications of intracystic bleomycin in 189 patients with brain tumors, Linnert et al 28 identified 5 patients (3%) with severe adverse effects and 6 patients (3%) with moderate adverse effects. Reported delayed complications include sensorineural hearing loss, 5,14 peritumoral edema, 19 visual loss, 33,35 hypothalamic dysfunction resulting in transient hypersomnolence, personality changes, poor memory, 17,35 cerebral ischemia, 5 hemiparesis, 22,35 progressive panhypopituitarism, 19 precocious puberty, 19 and death possibly related to a high individual and cumulative dose. 42 There have been a number of reported cases of moyamoya disease after intracystic bleomycin treatment for craniopharyngioma in patients who have also received radiotherapy, and it may be that radiotherapy sensitizes the vessels to bleomycin or vice versa.…”

Section: Intracystic Bleomycinmentioning

confidence: 99%

See 1 more Smart Citation

Intracystic treatments for craniopharyngioma

Steinbok¹,

Hukin

2010

FOC

View full text Add to dashboard Cite

Craniopharyngioma is a benign tumor histopathologically and in theory should be curable by radical resection. In practice, this tumor behaves like a chronic disease, with many issues related to the effect of the tumor itself and the various treatments on the adjacent structures, such as the pituitary stalk and gland, hypothalamus, visual apparatus, and suprasellar arteries. A multimodality approach to the management of these tumors may produce the optimal outcome, balancing disease control and quality of life. In this paper, the role of intracystic therapies is reviewed, with the major focus on intracystic bleomycin and interferon-α.

show abstract

Intracystic chemotherapy with bleomycin in the treatment of craniopharyngiomas

Abstract: Our results show that bleomycin can be an alternative in the treatment of cystic craniopharyngiomas or cystic recurrences, as it reduces surgical morbidity and improves clinical results.

Cited by 76 publications

References 14 publications

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

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

Management of craniopharyngiomas: Role of conservative strategies

Intracystic treatments for craniopharyngioma

Contact Info

Product

Resources

About