Proton therapy for adult craniopharyngioma : Experience of a single institution in 91 consecutive patients - Sorbonne Université Access content directly
Journal Articles Neuro-Oncology Year : 2023

Proton therapy for adult craniopharyngioma : Experience of a single institution in 91 consecutive patients

Arnaud Beddok
  • Function : Author
Nathaniel Scher
  • Function : Author
Claire Alapetite
Bertrand Baussart
  • Function : Author
Ghita Bentahila
  • Function : Author
Franck Bielle
Stephanie Bolle
  • Function : Author
Remi Dendale
  • Function : Author
Sylvain Dureau
  • Function : Author
Farid Goudjl
  • Function : Author
Sylvie Helfre
  • Function : Author
Hamid Mammar
  • Function : Author
Lucia Nichelli
  • Function : Author
Valentin Calugaru
  • Function : Author
Loïc Feuvret
  • Function : Author

Abstract

Background: Craniopharyngioma (CP) in adults is a rare benign tumor associated with many morbidities, with limited contemporary studies to define treatment, and follow-up guidelines. Methods: A single-center retrospective study was conducted on patients aged ≥ 18 years from 2006-2018 with CP and who were treated with proton therapy (PT). Late toxicity was defined as a minimum of 18 months from diagnosis. Overall survival (OS), local recurrence-free survival (LRFS), and toxicity were characterized using Kaplan-Meier and Cox regression analyses. Results: Ninety-one patients met the criteria, with a median age of 37 years (range 18-82 years). PT was conducted after tumor resection in 88 patients (97%), in 64 patients (70.3%) as an adjuvant strategy and in 27 (29.7%) after recurrent disease. Three patients received exclusive PT. A median MRI follow-up of 39 months revealed 35.2% complete response, 49.5% partial response, and 9.9% stable disease. Five patients developed local recurrence (LR). The pattern of failure study showed that these five LR were within the GTV volume. The 5-year LRFS was 92.0% [CI 95% 84.90-99.60]. All the patients were alive at the end of the follow-up. Patients requiring treatment adaptation during PT tend to have a higher risk of LR (P = .084). Endocrinopathy was the most frequent grade ≥ 2 late toxicity. Among patients who were symptom-free before the start of treatment, none developed hearing toxicity but four (9.8%) developed visual disorders and 10 (11.3%) symptomatic memory impairment. Patients with large tumors had a higher risk of developing symptomatic memory impairment (P = .029). Conclusion: Adults with CP treated with PT have favorable survival outcomes, with acceptable late toxicity. Prospective quality-of-life and neurocognitive studies are needed to define late adverse effects better.

Dates and versions

hal-04575580 , version 1 (15-05-2024)

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Arnaud Beddok, Nathaniel Scher, Claire Alapetite, Bertrand Baussart, Ghita Bentahila, et al.. Proton therapy for adult craniopharyngioma : Experience of a single institution in 91 consecutive patients. Neuro-Oncology, 2023, 25 (4), pp.710-719. ⟨10.1093/neuonc/noac210⟩. ⟨hal-04575580⟩
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