Re-irradiation for recurrent craniopharyngioma

Abstract Purpose Re-irradiation is rarely administered to patients with recurrent craniopharyngioma due 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 two courses of fractionated radiation therapy (RT). Methods A retrospective study was performed of all patients with craniopharyngioma treated with two courses of fractionated RT at a single institution. Electronic medical records and radiotherapy records were reviewed. Results We identified four eligible patients with recurrent craniopharyngioma. With a median follow-up of 33 months after re-irradiation, three patients attained disease control; one patient developed progressive disease, 27 months after re-irradiation. In three evaluable patients, vision remained stable or improved after re-irradiation; one patient had no light perception prior to re-irradiation. None of the patients experienced additional endocrine toxicities following re-irradiation, apart from one patient who had low sTSH prior to re-irradiation and later developed hypothyroidism following treatment. Conclusions Re-irradiation 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.