Craniopharyngioma medical therapy: Difference between revisions
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==Medical Therapy == | ==Medical Therapy == | ||
*The mainstay of therapy for craniopharyngioma is surgery with or without [[Radiation therapy|radiation]]. | *The mainstay of therapy for craniopharyngioma is surgery with or without [[Radiation therapy|radiation]].<ref name="pmid17630614">{{cite journal |vauthors=Garrè ML, Cama A |title=Craniopharyngioma: modern concepts in pathogenesis and treatment |journal=Curr. Opin. Pediatr. |volume=19 |issue=4 |pages=471–9 |date=August 2007 |pmid=17630614 |doi=10.1097/MOP.0b013e3282495a22 |url=}}</ref> | ||
*There are certain [[Indications and usage|indications]] for medical therapy mostly in treating [[Tumors|recurrent tumors]]. | *There are certain [[Indications and usage|indications]] for medical therapy mostly in treating [[Tumors|recurrent tumors]].<ref name="pmid7885544">{{cite journal |vauthors=Weiner HL, Wisoff JH, Rosenberg ME, Kupersmith MJ, Cohen H, Zagzag D, Shiminski-Maher T, Flamm ES, Epstein FJ, Miller DC |title=Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome |journal=Neurosurgery |volume=35 |issue=6 |pages=1001–10; discussion 1010–1 |date=December 1994 |pmid=7885544 |doi= |url=}}</ref> | ||
*The use of [[Subcutaneous tissue|subcutaneous]] [[Interferon-alpha|pegylated interferon alpha-2b]] to manage [[Cyst|cystic]] recurrences can result in durable responses.<ref>Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc</ref> | *The use of [[Subcutaneous tissue|subcutaneous]] [[Interferon-alpha|pegylated interferon alpha-2b]] to manage [[Cyst|cystic]] recurrences can result in durable responses.<ref>Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc</ref> | ||
*The [[Chemotherapy|chemotherapy drugs]] [[Paclitaxel]] and [[Carboplatin]] have shown a clinical significance in increasing the survival rate. | *The [[Chemotherapy|chemotherapy drugs]] [[Paclitaxel]] and [[Carboplatin]] have shown a clinical significance in increasing the survival rate.<ref name="pmid1260697">{{cite journal |vauthors=Petito CK, DeGirolami U, Earle KM |title=Craniopharyngiomas: a clinical and pathological review |journal=Cancer |volume=37 |issue=4 |pages=1944–52 |date=April 1976 |pmid=1260697 |doi= |url=}}</ref> | ||
*Cystic recurrences may be treated with intracavitary instillation of varying agents via [[stereotactic]] delivery or placement of an [[Catheter|Ommaya catheter]]. | *Cystic recurrences may be treated with intracavitary instillation of varying agents via [[stereotactic]] delivery or placement of an [[Catheter|Ommaya catheter]]. | ||
*[[Stereotactic surgery|Stereotactic]] agents have included [[Radioactive tracer|radioactive P-32]] or other radioactive compounds, [[bleomycin]] or [[interferon-alpha]]. | *[[Stereotactic surgery|Stereotactic]] agents have included [[Radioactive tracer|radioactive P-32]] or other radioactive compounds, [[bleomycin]] or [[interferon-alpha]]. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]
Overview
The predominant therapy for craniopharyngioma is surgical resection. Adjunctive chemotherapy and radiation may be required. Subcutaneous pegylated interferon alpha-2B has been used to treat cystic recurrences. It can also be treated with intracavitary instillation of radioactive P-32, bleomycin or interferon-alpha via stereotactic delivery or placement of an Ommaya catheter. Paclitaxel and carboplatin have shown to prevent recurrence of malignant craniopharyngiomas. Intracavitary bleomycin reduces cyst size and toughens and thickens the cyst wall, thereby facilitating surgical excision of a cyst membrane that otherwise might fragment at the time of open craniotomy. Reports of intracystic bleomycin use are limited. Other agents like interferon alpha are being tested in recent days.
Medical Therapy
- The mainstay of therapy for craniopharyngioma is surgery with or without radiation.[1]
- There are certain indications for medical therapy mostly in treating recurrent tumors.[2]
- The use of subcutaneous pegylated interferon alpha-2b to manage cystic recurrences can result in durable responses.[3]
- The chemotherapy drugs Paclitaxel and Carboplatin have shown a clinical significance in increasing the survival rate.[4]
- Cystic recurrences may be treated with intracavitary instillation of varying agents via stereotactic delivery or placement of an Ommaya catheter.
- Stereotactic agents have included radioactive P-32 or other radioactive compounds, bleomycin or interferon-alpha.
- None of these approaches have shown efficacy against solid portions of the tumor.[5] [6]
References
- ↑ Garrè ML, Cama A (August 2007). "Craniopharyngioma: modern concepts in pathogenesis and treatment". Curr. Opin. Pediatr. 19 (4): 471–9. doi:10.1097/MOP.0b013e3282495a22. PMID 17630614.
- ↑ Weiner HL, Wisoff JH, Rosenberg ME, Kupersmith MJ, Cohen H, Zagzag D, Shiminski-Maher T, Flamm ES, Epstein FJ, Miller DC (December 1994). "Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome". Neurosurgery. 35 (6): 1001–10, discussion 1010–1. PMID 7885544.
- ↑ Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc
- ↑ Petito CK, DeGirolami U, Earle KM (April 1976). "Craniopharyngiomas: a clinical and pathological review". Cancer. 37 (4): 1944–52. PMID 1260697.
- ↑ Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc
- ↑ Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc