National UK guidelines for the management of paediatric craniopharyngioma

Gan, Hoong-Wei; Morillon, Paul; Albanese, Assunta; Aquilina, Kristian; Chandler, Chris; Chang, Yen-Ching; Drimtzias, Evangelos; Farndon, Sarah; Jacques, Thomas S.; Korbonits, M; Kuczynski, Adam M.; Limond, Jennifer; Robinson, Louise; Simmons, Ian; Thomas, Nick; Thomas, Sophie; Thorp, Nicola; Vargha‐Khadem, Faraneh; Warren, Daniel; Zebian, Bassel; Mallucci, Conor; Spoudeas, Helen

doi:10.1016/s2213-8587(23)00162-6

Cited by 10 publications

(3 citation statements)

References 149 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on recent reports, hypothalamus-sparing surgical strategies are preferred in childhood-onset CP patients presenting initially with a sellar mass involving hypothalamic structures ( 8 , 10 , 25 ). Accordingly, radiooncological approaches for residual tumor treatment after incomplete hypothalamus-sparing surgical interventions play a major role in the current consensus on appropriate treatment for CP patients ( 11 , 26 ). The occurrence of disease progression or not before irradiation was not associated with a difference in EFS.…”

Section: Discussionmentioning

confidence: 99%

Outcome after proton beam therapy versus photon-based radiation therapy in childhood-onset craniopharyngioma patients—results of KRANIOPHARYNGEOM 2007

Friedrich,

Boekhoff,

Bischoff

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

BackgroundProton beam therapy (PBT) is being increas16ingly used to treat residual craniopharyngioma (CP) after hypothalamus-sparing surgery. Compared to photon-based radiation therapy (XRT) with PBT, less irradiation in the penumbra reduces the scattered dose to critical organs neighboring but outside the area of treatment, minimizing the risk of sequelae.Patients and methodsBetween 2007 and 2019, 99 of 290 (34%) childhood-onset CP patients recruited in KRANIOPHARYNGEOM 2007 received external radiation therapy (RT) (65% PBT, 35% XRT). Outcome was analyzed in terms of survival, endocrinological and anthropometric parameters (BMI and height SDS), quality of life (QoL using PEDQOL), and functional capacity (FMH) with special regard to irradiation technique.ResultsPBT became predominant (used in 43% and 72% of all irradiated patients registered within the first and second halves of the recruitment period, between 2008 and 2013 and 2013 and 2018, respectively). Five-year event-free survival rates after PBT or XRT were comparable (92% ± 4% vs. 91% ± 4%, p = 0.42) and higher than for the whole cohort since diagnosis, including non-RT patients (37% ± 4%). Radiation doses to the hypothalamus and pituitary did not differ between PBT and XRT. Endocrine deficits due to disturbances of the hypothalamic-pituitary axis (HPA) were already common before irradiation. During the first 5 years after CP diagnosis/RT, no differences between PBT, XRT, and non-RT CP patients concerning functional capacity and anthropometric parameters have been obtained. Only for the PEDQOL domain “physical function”, parental-assessed QoL was lower 12 months after PBT versus XRT or non-RT patients.ConclusionQoL, functional capacity, degree of obesity, and endocrinopathy varied over time from diagnosis, but by 5 years, there was no significant difference between PBT and XRT upfront or delayed, nor was there any compromise in historic survival rates, which remained high >90%. RT of any type is extremely effective at stabilizing disease after hypothalamic-sparing surgery. The purported specific benefits of PBT-reducing sequelae are not proven in this study where the organ of critical interest is itself diseased, increasing an urgent need to better address and treat the tumor-induced endocrine harm from diagnosis in dedicated pituitary services. Other hypothesized benefits of PBT versus XRT on vascular events and secondary cancers await longer comparison.Clinical trial registration numberhttps://clinicaltrials.gov/study/, identifier NCT01272622.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcome after proton beam therapy versus photon-based radiation therapy in childhood-onset craniopharyngioma patients—results of KRANIOPHARYNGEOM 2007

Friedrich,

Boekhoff,

Bischoff

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…However, the recently published National UK guidelines for the management of pediatric craniopharyngioma do not provide adequate evidence to endorse IFNa as the preferred first-line treatment option. Additionally, intracystic bleomycin and radioisotopes lack robust support as the primary strategies for ACP treatment (124).…”

Section: Intracavitary Chemotherapeutic Treatmentmentioning

confidence: 99%

“…While intracavitary chemotherapy or cyst aspiration generally show greater efficacy than conservative approaches, their PFS have not been well described compared to surgical resection in existing literature. In cases of childhood-onset CP accompanied by hydrocephalus, a staged approach involving minimally invasive cyst decompression followed by cyst aspiration or tumor resection is recommended to mitigate clinical risks and achieve effective tumor control (124).…”

Section: Childhoodonset Craniopharyngiomamentioning

confidence: 99%

Advances in the treatment of Adamantinomatous craniopharyngioma: How to balance tumor control and quality of life in the current environment: a narrative review

Chen,

Ai,

Sun

2023

Front. Oncol.

View full text Add to dashboard Cite

Adamantinomatous craniopharyngioma (ACP) presents a significant challenge to neurosurgeons despite its benign histology due to its aggressive behavior and unique growth patterns. This narrative review explores the evolving landscape of ACP treatments and their efficacy, highlighting the continuous development in therapeutic approaches in recent years. Traditionally, complete resection was the primary treatment for ACP, but surgical -related morbidity have led to a shift. The invasive nature of the finger-like protrusions in the histological structure results in a higher recurrence rate for ACP compared to papillary craniopharyngioma (PCP), even after complete macroscopic resection. Given this, combining subtotal resection with adjuvant radiotherapy has shown potential for achieving similar tumor control rates and potentially positive endocrine effects. Simultaneously, adjuvant treatments (such as radiotherapy, intracystic treatment, and catheter implantation) following limited surgery offer alternative approaches for sustained disease control while minimizing morbidity and alleviating clinical symptoms. Additionally, advances in understanding the molecular pathways of ACP have paved the way for targeted drugs, showing promise for therapy. There is a diversity of treatment models for ACP, and determining the optimal approach remains a subject of ongoing debate in the present context. In order to achieve a good-term quality of life (QOL), the main goal of the cyst disappearance or reduction of surgical treatment is still the main. Additionally, there should be a greater emphasis on personalized treatment at this particular stage and the consideration of ACP as a potentially chronic neurosurgical condition. This review navigates the evolving landscape of ACP therapies, fostering ongoing discussions in this complex field.

show abstract

Presentation and outcomes of paediatric craniopharyngioma in the west of Scotland: a 25 year experience

Kuah,

Lucas-Herald,

McCarrison

et al. 2024

J Neurooncol

View full text Add to dashboard Cite

National UK guidelines for the management of paediatric craniopharyngioma

Cited by 10 publications

References 149 publications

Outcome after proton beam therapy versus photon-based radiation therapy in childhood-onset craniopharyngioma patients—results of KRANIOPHARYNGEOM 2007

Outcome after proton beam therapy versus photon-based radiation therapy in childhood-onset craniopharyngioma patients—results of KRANIOPHARYNGEOM 2007

Advances in the treatment of Adamantinomatous craniopharyngioma: How to balance tumor control and quality of life in the current environment: a narrative review

Presentation and outcomes of paediatric craniopharyngioma in the west of Scotland: a 25 year experience

Contact Info

Product

Resources

About