Early adjuvant radiotherapy toward long-term survival and better quality of life for craniopharyngiomas - a study in single institute

Objectives: The objective of the study is to compare survival and quality of life (QoL) by the delivery time of adjuvant radiotherapy (RT), early or late, for craniopharyngiomas. Methods and materials: Fifty patients received RT between 1985 and 2002. Early RT (n=25) was delivered within 3 months after initial surgery, whereas late RT (n=25) was combined with or without reoperation after progression or relapse. Radiation dose ranged from 45 to 55.8 Gy with a median of 54 Gy. The median follow-up was 130 months. Results: Progression-free survival rates at 5 and 10 years were 95.9 and 91.2%, respectively. The overall or progression-free survival was not influenced by RT time. Initial tumor size was the only prognostic factor (p=0.034) for progression-free survival in univariate analysis. Better visual acuity or field was maintained, and diabetes insipidus was partly improved with early RT, but all were deteriorated as tumor progressed without early RT. Visual functions were not worsened after late RT. Conclusions: The survival was excellent with adjuvant RT, early or late. Poor QoL with late RT resulted from relapsed tumor and repeated surgery but was not associated with RT itself. Thus, early RT with precision technique is highly recommended for better QoL and excellent survival, unless contraindicated.