Novalis Shaped Beam Radiation Treatment for Craniopharyngiomas

Yee, Gi Taek; Han, Seong Rok; Yoon, Sang Won; Choi, Chan Young; Lee, Dong Joon; Whang, Choong Jin

Abstract

OBJECTIVE
To evaluate the effectiveness of Novalis shaped beam radiation treatment as an adjuvant treatment in patients with craniopharyngiomas.
METHODS
We reviewed 8 patients with craniopharyngiomas who had recurring tumors during follow-up or had residual lesions after primary surgery. Three of 8 patients were found to have recurrence after gross total excision of the tumor and 5 patents had residual lesions after subtotal resection. All patients were treated with fractionated stereotactic radiation treatment(FSRT) using Novalis system. The mean age of patients was 28 years (range 16~52). The median irradiation dose per fraction was 1.7Gy (range 1.7~2.0). The median fraction number was 23 (range 15~25), and the median total dose was 39.1Gy (range 25.5~42.5). Follow-up included MR imaging, and ophthalmologic and endocrine examinations.
RESULTS
The median follow-up period was 23 months (range 12~43). The local tumor control rate was 87.5%. One patient had a recurring tumor, in which cystic change developed 2 months after FSRT. Four patients showed a decrease in size of their tumor, while 3 patients remained stable. Seven out of 8 patients had hormonal dysfunction that remained unchanged after initial surgery. No further progression of visual impairment was observed.
CONCLUSION
FSRT using Novais system is effective and safe for the treatment of recurring or residual craniopharyngiomas without toxicity like optic neuropathy.