Stereotactic radiotherapy using Novalis for craniopharyngioma adjacent to optic pathways

Craniopharyngioma has benign histological character. However, because of proximity to optic pathways, pituitary gland, and hypothalamus, it may cause severe and permanent damage to such critical structures and can even be life threatening. Total surgical resection is often difficult. This study aims to evaluate treatment results of Novalis stereotactic radiotherapy (SRT) for craniopharyngioma adjacent to optic pathways. Ten patients (six men, four women) with craniopharyngioma and median age of 56.5 years (range 10-74 years) were treated by SRT using Novalis from July 2006 through March 2009. Median volume of tumor was 7.9 ml (range 1.1-21 ml). Three-dimensional noncoplanar five- or seven-beam SRT or coplanar five-beam SRT with intensity modulation was performed. Total dose of 30-39 Gy in 10-15 fractions (median 33 Gy) was delivered to the target. Ten patients were followed up for 9-36 months (median 25.5 months). Response rate was 80% (8/10), and control rate was 100%. Improvement of neurological symptoms was observed in five patients. No serious complications due to SRT were found. SRT for craniopharyngioma may be a safe and effective treatment. Longer follow-up is necessary to determine long-term tumor control or late complications.