دورية أكاديمية
أعرض في EDS

Patterns of Care in Craniopharyngioma: Clinical Outcomes After Surgery and Radiation Therapy in a Real-World Setting.

التفاصيل البيبلوغرافية
العنوان: Patterns of Care in Craniopharyngioma: Clinical Outcomes After Surgery and Radiation Therapy in a Real-World Setting.
المؤلفون: Ghosh S; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India., Goda JS; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India. Electronic address: godajayantsastri@gmail.com., Chatterjee A; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India., Shetty P; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India., Sahay A; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India., Dasgupta A; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India., Epari S; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India., Sahu A; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India., Singh V; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India., Gupta T; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India., Moyiadi AA; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India., Jalali R; Neurooncology Disease Management Group, Tata Memorial Centre, Dr Ernest Borges Marg & Homi Bhabha National Institute, Trombay, Mumbai, India.
المصدر: World neurosurgery [World Neurosurg] 2024 Jan; Vol. 181, pp. e809-e819. Date of Electronic Publication: 2023 Nov 03.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York : Elsevier
مواضيع طبية MeSH: Craniopharyngioma*/radiotherapy , Craniopharyngioma*/surgery , Pituitary Neoplasms*/radiotherapy , Pituitary Neoplasms*/surgery, Humans ; Male ; Adolescent ; Treatment Outcome ; Retrospective Studies ; Neoplasm Recurrence, Local
مستخلص: Objective: Craniopharyngioma (CP) is a benign neuroepithelial tumor generally treated with maximal safe resection and radiation therapy (RT) in incompletely resected CP or in recurrent tumors to achieve long-term control. We analyzed the clinical outcomes of patients with CPs treated with a multimodality approach.
Patients and Methods: A retrospective clinical audit of histologically proven CPs registered between 2008 and 2019 at a specialized neuro-oncology center in India was performed. Time-to-event outcomes (overall survival [OS] and progression-free survival [PFS]) were analyzed.
Results: One hundred and twenty-two patients with CP were analyzed. The median age of the population was 14 years (interquartile range [IQR], 8-26) with a significant male preponderance. Gross total resection was achieved in only 25% of patients. At a median follow-up of 57.1 months (IQR, 27.8-87.8), 5-year estimates of PFS and OS were 52% (95% confidence interval, 46%-63.4%) and 85.8% (95% confidence interval, 78.6%-93%), respectively. Recurrence or progression was observed in 48 of 122 patients (39.3%) at a median time of 84.4 months (IQR, 24.7-174.8). On multivariate analysis, the absence of residual disease (P = 0.004), near-total resection (P = 0.035), and use of up-front adjuvant RT (P < 0.001) significantly improved the 5-year PFS, whereas the absence of extracavernous extension (P = 0.058) and any use of postoperative RT (P = 0.026) significantly improved the 5-year OS.
Conclusions: This study represents one of the largest single-institutional series of CPs, showing improved PFS with up-front adjuvant RT in most cases of CP. Deferring adjuvant RT should be considered only in patients with no evidence of residual disease (as shown on dedicated sellar imaging) after primary surgery.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Adjuvant therapy; Craniopharyngioma; Multimodality; Radiation
تواريخ الأحداث: Date Created: 20231103 Date Completed: 20240118 Latest Revision: 20240701
رمز التحديث: 20240701
DOI: 10.1016/j.wneu.2023.10.138
PMID: 37923012
قاعدة البيانات: MEDLINE
الوصف
تدمد:1878-8769
DOI:10.1016/j.wneu.2023.10.138