Sixty-seven consecutive patients with mixed cystic and solid
craniopharyngioma treated by Gamma Knife radiosurgery combined with stereotactic
brachytherapy from October 1996 to December 2005 were selected for retrospective analysis. The inclusion criterion was the patients who survived for at least 5 years after combined treatment. There were 39 male and 28 female patients and the mean age was 31.5 years (ranged from 3 to 70 years). The clinical evaluations including neurological, neuro-ophthalmological, and neuro-endocrinological examinations, assessment of comprehensive quality of life and neuroimaging examinations were performed periodically. The actuarial survival rates and the mean survival time were calculated by using Kaplan-Meier product limit method. The rates were compared using the χ(2) test.
RESULTS: Follow-up period varied from 60 to 168 months, with an average of 114 months. The
tumor response rate gained from combination treatment with Gamma Knife radiosurgery and stereotactic intracavitary
brachytherapy for predominantly solid and cystic
craniopharyngiomas were 10/12 and 90.9% respectively, and 89.6% in all. Mean survival after combination treatment was (110 ± 9) months. The mean survival of patients with predominantly solid and cystic
craniopharyngioma were (97 ± 12) months and (120 ± 14) months and the actuarial 10-year survival rates were 7/12 and 69.1%. There was no statistics difference in
tumor response rate and 10-year survival rate between 2 groups of patients with predominantly solid and cystic
craniopharyngioma. The actuarial 5-, 6-, 7-, 8-, 9- and 10-year survival rates were 90.5%, 85.7%, 83.3%, 76.4%, 69.4% and 60.0% respectively. The decreased visual acuity had improved in 68.3% at 6 months postoperatively and in 70.0% in long term results. Comprehensive quality of life in long term follow-up of 67 patients was excellent in 28 cases(41.8%), good in 19 cases(28.4%), fair in 17 cases(25.4%) and poor in 3 cases(4.5%), respectively. The side effects that occurred 6 to 12 months
after treatment were worsening of visual acuity (4 patients), dysfunction of hypothalam (4 patients) and
third nerve palsy was found in 1 patents 5 years
after treatment. The rate of complications was 13.4%.
CONCLUSION: