Stereotactic intratumour irradiation with nuclide for craniopharyngiomas.

OBJECTIVE

Craniopharyngiomas is a kind of intractable tumor in neurosurgery. Since the radical excision is very difficult and occasionally hazardous because of its deep location and close neighbouring to critical cerebral structures, it is necessary to look for a simple and effective method.

PATIENTS AND METHODS

Stereotactic intratumour irradiation with instillation of nuclide colloid was performed in 220 patients with craniopharyngiomas (altogether 265 times), of whom, 130 were male and 90 female. Their ages ranged from 5 to 69 years. The syndromes of optic path's impairment were present in all of the patients. CT or MRI scan showed cystic tumour in 125 patients, solid and cystic in 80 and solid in 15. No severe complications and death were related to the operation.

RESULTS

150 patients were followed up for 2 months to 7 years (average 3.5 years). Tumours disappeared in 92 patients (61.4%), decreased dramatically in 20 (13.4%), decreased less than 50% in 19 (12.6%), and increased in 15 (10%); and there were 4 deaths (2.6%).

CONCLUSIONS

Stereotactic intratumour irradiation with instillation of nuclide colloid is effective in the patients with craniopharyngiomas. Beta-emitting isotopes (P-32 and Y-90) are the preferred internal radiation source because of their limited penetration of the energy released and the greater ease of handling. A calculated dose of 20 000 rads to the cyst wall is recommended.