BACKGROUND Craniopharyngioma is a benign tumor that commonly develops within the suprasellar region. The tumor and treatment can have debilitating consequences for pediatric and adult patients, including vision loss and pituitary/hypothalamic dysfunction. Most craniopharyngioma series focus on treatment of the pediatric population. We evaluated the outcomes of all adult craniopharyngioma patients treated at our institution using proton therapy to report outcomes for disease control, treatment-related toxicity, and tumor response. METHODS We analyzed 14 adult patients (≥ 22 years old). All patients had gross disease at the time of radiotherapy. Five were treated for de novo disease and 9 for recurrent disease. Patients received double-scattered conformal proton therapy to a mean dose of 54 GyRBE in 1.8 GyRBE/fraction (range 52.2-54 GyRBE). Weekly magnetic resonance imaging (MRI) helped to evaluate tumor changes during radiotherapy. RESULTS With median clinical and radiographic follow-up of 29 and 26 months, respectively, the 3-year local control and overall survival rates were both 100%. There were no grade 3 or greater acute or late radiotherapy-related side effects. There was no radiotherapy-related vision loss or optic neuropathy. No patients required intervention or treatment replanning due to tumor changes during radiotherapy. Two patients experienced transient cyst expansion at their first post-radiotherapy MRI. Both patients were followed closely clinically and radiographically and had subsequent dramatic tumor/cyst regression, requiring no interventions. CONCLUSIONS Our data support the safety and efficacy of proton therapy in the treatment of adult craniopharyngioma as part of primary or salvage treatment. We recommend early consideration of radiotherapy. TRIAL REGISTRATION Clinical Trials.gov Identifier: NCT03224767. Accessed December 3, 2019.

中文翻译：

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质子治疗成人颅咽管瘤后的临床结果：单机构队列研究。

背景技术颅咽管瘤是一种良性肿瘤，通常在鞍上区域发展。肿瘤和治疗可能给小儿和成年患者带来虚弱的后果，包括视力下降和垂体/下丘脑功能障碍。大多数颅咽管瘤系列研究集中在儿科人群的治疗上。我们评估了在我们机构中使用质子疗法治疗的所有成人颅咽管瘤患者的结局，以报告疾病控制，与治疗相关的毒性和肿瘤反应的结局。方法我们分析了14名成年患者（≥22岁）。所有患者在放疗时均患有严重疾病。有5例因新发疾病而接受治疗，而9例因复发而接受治疗。患者接受了双散射共形质子治疗，平均剂量为1.8 GyRBE /分数的54 GyRBE（范围为52.2-54 GyRBE）。每周磁共振成像（MRI）有助于评估放疗期间的肿瘤变化。结果分别进行了29个月和26个月的中位临床和影像学随访，三年局部控制率和总生存率均为100％。没有3级或更高的急性或晚期放疗相关副作用。没有放疗相关的视力丧失或视神经病变。由于放疗过程中的肿瘤变化，没有患者需要干预或治疗规划。两名患者在首次放射治疗后MRI时经历了短暂的囊肿扩张。两名患者均在临床和影像学上受到密切随访，随后发生了明显的肿瘤/囊肿消退，无需干预。结论我们的数据支持质子治疗作为主要或挽救性治疗的一部分成人颅咽管瘤的安全性和有效性。我们建议及早考虑放疗。试验注册Clinical Trials.gov标识符：NCT03224767。于2019年12月3日访问。