Foran Sarah J, Laperriere Normand, Edelstein Kim, Janzen Laura, Tadic Tony, Ramaswamy Vijay, Shultz David, Gentili Fred, Bouffet Eric, Tsang Derek S
University of Toronto, Faculty of Medicine, Toronto, Canada.
Radiation Medicine Program, Princess Margaret Cancer Center, University Health Network, Toronto, Canada.
Adv Radiat Oncol. 2020 Aug 7;5(6):1305-1310. doi: 10.1016/j.adro.2020.07.020. eCollection 2020 Nov-Dec.
Reirradiation is rarely administered to patients with recurrent craniopharyngioma owing to concerns regarding visual and endocrine side effects. The purpose of this case series was to evaluate our institutional experience of patients with craniopharyngioma treated with 2 courses of fractionated radiation therapy.
A retrospective study was performed of all patients with craniopharyngioma treated with 2 courses of fractionated radiation therapy at a single institution. Electronic medical records and radiation therapy records were reviewed.
We identified 4 eligible patients with recurrent craniopharyngioma. With a median follow-up of 33 months after reirradiation, 3 patients attained disease control; 1 patient developed progressive disease, 27 months after reirradiation. In 3 evaluable patients, vision remained stable or improved after reirradiation; one patient had no light perception before reirradiation. None of the patients experienced additional endocrine toxicities after reirradiation, apart from one patient who had low serum thyroid stimulating hormone before reirradiation and later developed hypothyroidism after treatment.
Reirradiation may represent a safe and effective therapeutic option for selected patients with recurrent, refractory craniopharyngioma and without other salvage treatment options. Larger studies with longer-term follow up are warranted to better understand outcomes in these patients.
由于担心视觉和内分泌副作用，复发性颅咽管瘤患者很少接受再程放疗。本病例系列的目的是评估我们机构对接受两程分割放疗的颅咽管瘤患者的治疗经验。
对在单一机构接受两程分割放疗的所有颅咽管瘤患者进行回顾性研究。查阅了电子病历和放疗记录。
我们确定了4例符合条件的复发性颅咽管瘤患者。再程放疗后中位随访33个月，3例患者病情得到控制；1例患者在再程放疗27个月后病情进展。在3例可评估的患者中，再程放疗后视力保持稳定或改善；1例患者在再程放疗前无光感。除1例患者在再程放疗前血清促甲状腺激素水平低且治疗后出现甲状腺功能减退外，其他患者在再程放疗后均未出现额外的内分泌毒性反应。
对于选定的复发性、难治性颅咽管瘤且无其他挽救治疗选择的患者，再程放疗可能是一种安全有效的治疗选择。有必要进行更大规模、长期随访的研究，以更好地了解这些患者的治疗结果。
