Experience of external beam radiotherapy given adjuvantly or at relapse following surgery for craniopharyngioma

Abstract Background and purpose Evaluation of effect of timing of external beam radiation therapy (EBRT) following surgery for craniopharyngioma. Materials and methods Between 1976 and 2002, 87 patients (28 children) received EBRT in a regional referral centre. Forty-four patients received EBRT adjuvantly and 43 on relapse. The median total dose was 42.5Gy (range 34.7–52.5Gy) in 2.25–2.83Gy fractions over a median of 20 days (range 17–32). Effect of EBRT timing, type of original surgery, age on survival, progression-free survival (PFS) and quality of life (QOL) was studied. Results Survival from diagnosis was 86 and 76% and PFS was 78 and 66% at 10 and 20 years, respectively, with no significant difference seen between those treated adjuvantly or at relapse or according to age. QOL deteriorated significantly from diagnosis to last follow-up. Excluding patients who relapsed following EBRT, QOL did not deteriorate significantly overall ( P =0.35). Children had worse QOL and greater morbidity at all timepoints compared to adults. Conclusions EBRT is effective both adjuvantly and at relapse. QOL deteriorates over time-relapse following EBRT was the only significant factor. Children have greater morbidity compared to adults, but no evidence for greater EBRT-induced toxicity was seen.