Jose C C, Rajan B, Ashley S, Marsh H, Brada M
Neuro-oncology Unit, Royal Marsden Hospital, Sutton, Surrey, UK.
Clin Oncol (R Coll Radiol). 1992 Sep;4(5):287-9. doi: 10.1016/s0936-6555(05)81101-x.
Twenty-five patients with craniopharyngioma received radiotherapy at the time of recurrence. The 10-year progression free survival and survival from the time of recurrence were 72% and 77% respectively. Nineteen patients underwent surgery prior to radiotherapy (6 partial excision, 4 decompression and 9 cyst aspiration). The extent of resection at the time of recurrence did not influence the outcome. Apart from pituitary failure there was no serious morbidity associated with this approach. The results of radiotherapy at recurrence are similar to those of conservative surgery and radiotherapy at the time of presentation. It suggests that radiotherapy remains an effective treatment modality at the time of recurrence of craniopharyngioma and it may therefore be delayed in situations where immediate radiation is not advisable. However, the high recurrence rate in incompletely excised craniopharyngioma, together with the potential risk of additional morbidity and mortality from undiagnosed progressive tumour and salvage surgery, would argue for a policy of radiotherapy as part of the initial treatment of incompletely excised craniopharyngioma.
25例颅咽管瘤患者在复发时接受了放疗。10年无进展生存率和自复发时起的生存率分别为72%和77%。19例患者在放疗前接受了手术（6例部分切除、4例减压和9例囊肿抽吸）。复发时的切除范围不影响治疗结果。除垂体功能减退外，该治疗方法无严重并发症。复发时放疗的结果与初次就诊时保守手术及放疗的结果相似。这表明放疗在颅咽管瘤复发时仍是一种有效的治疗方式，因此在不宜立即放疗的情况下可推迟放疗。然而，不完全切除的颅咽管瘤复发率高，加上未诊断出的进行性肿瘤和挽救性手术带来的额外发病和死亡风险，支持将放疗作为不完全切除的颅咽管瘤初始治疗一部分的策略。
