NCO-05LONG TERM FUNCTIONAL AND CLINICAL OUTCOME IN CHILDREN WITH CRANIOPHARYNGIOMA TREATED WITH HIGH PRECISION STEREOTACTIC CONFORMAL RADIOTHERAPY (SCRT): DATA FROM A PROSPECTIVE TRIAL

BACKGROUND: To report prospective detailed outcome data in young patients with residual/recurrent craniopharyngioma treated with Stereotactic Conformal focal radiotherapy (SCRT). METHODS: 39 patients (27 males, 12 females; median age-11 years) underwent prospective detailed serial longitudinal evaluation of neuropsychological/ neurocognitive, and neuroendocrine function at baseline and follow-up after RT. RESULTS: Near total excision as the commonest surgery (82%). Mild/moderate hydrocephalus was observed in 85% and severe in 15%. Impaired vision was observed in 2 patients (5.2%). At a median follow-up of 49.5months (IQ range 12-67 months). 37 patients were controlled at last follow-up with a 10-yr OS of 92% and 10-yr PFS of 84%. Pre-RT mean VQ/MQ, performance IQ (PQ) and FSIQ were 84.95, 80.5 and 77.1 respectively and improved to 96.9,104 and 91 respectively at 5 years follow-up following RT. Pre RT endocrine deficit in 1 or 2 axes was seen in 50% of patients. Involvement of additional axes was seen in 21% patients. LOTCA scores showed improvement with time in attention concentration domain following SCRT. Mean trait-anxiety scores both in children and adolescents was poor at baseline which improved at 5-years follow-up following SCRT. CONCLUSION: The clinical outcome of craniopharyngioma patients had borderline to below average IQ and poor endocrinal function even before starting RT. We observed an improvement in IQ status 5 years post SCRT.