International Journal of Hematology and Oncology 2024, Vol 34, Num 3 Page(s): 123-129
Evaluation of Linear Accelerator (Linac)-Based Stereotactic Radiosurgery (Srs) for The Treatment of Craniopharyngiomas

Selcuk DEMIRAL1, Murat BEYZADEOGLU1, Omer SAGER1, Ferrat DINCOGLAN1, Hakan GAMSIZ1, Bora UYSAL1, Kaan OYSUL1, Esin GUNDEM1, Bahar DIRICAN1, Sait SIRIN2

1Gulhane Military Medical Academy, Department of Radiation Oncology, Ankara, TURKEY
2Gulhane Military Medical Academy, Department of Neurosurgery, Ankara, TURKEY

Keywords: Craniopharyngioma, Stereotactic Radiosurgery (SRS), Linear Accelerator (LINAC)
Although benign histologically, craniopharyngiomas may display clinically malignant behavior with a strong propensity for recurrence. Contemporary therapeutic approaches for craniopharyngiomas include stereotactic irradiation in the form of Stereotactic Radiosurgery (SRS) or Fractionated Stereotactic Radiation Therapy (FSRT) as part of multimodality treatment particularly when complete surgical removal is not feasible. In this study, we evaluate the use of Linear Accelerator (LINAC)-based SRS in the multidisciplinary management of patients with craniopharyngiomas. Between July 1998 and July 2013, 20 patients (11 male, 9 female) with residual or recurrent craniopharyngiomas were treated using LINAC-based SRS at Department of Radiation Oncology, Gulhane Military Medical Academy. Median age was 37 (9-69) years. Median tumor volume was 1.1 (0.9-6.9) cc. Median dose was 13 Gy (range: 10-16 Gy) prescribed to the 80%-95% isodose line encompassing the target volume. Median follow-up time was 47 (7-93) months. Overall local control rate was 88% at 1 year, 79% at 3 years and 66% at 5 years. Three and 5-year progression free survival rates were 95% and 91% whereras 3 and 5-year overall survival rates were 94% and 88%, respectively. Our study supports the usage of LINAC-based SRS as a safe and effective management strategy for patients with recurrent or residual craniopharyngiomas.