Role of protontherapy in craniopharyngioma treatment
L. Feuvreta, L. Feuvret*b (Dr), A. Beddokc (Dr)
a Paris, FRANCE ; b APHP PITIE SALPETRIERE RADIOTHERAPIE PARIS 75 - INSTITUT CURIE CENTRE DE PROTONTHERAPIE ORSAY 91, Paris, FRANCE ; c INSTITUT CURIE CENTRE DE PROTONTHERAPIE ORSAY 91, Orsay, FRANCE
The craniopharyngioma is a rare, slow-growing benign tumor. Half of cases occur in adults but data are scarce in the literature. Radical resection was recommended as the gold standard of treatment. Nevertheless, due to their infiltrative growth behavior, the resection appears as a major challenge. Currently that is why subtotal resection (STR) and radiation therapy (RT) hold a main role as reported in two meta-analyses, drawing the conclusion that safe STR-RT may have similar outcomes as GTR in adult population. Advancements in the delivery of RT have included, recently, intensity-modulated radiation therapy (IMRT) and proton therapy, which have increased the ability to maximize dose to the tumor while sparing normal structures. It is necessary to determine the context in which a particular technique may have a greater advantage, as each technique may result not only in differences in target and normal tissue dose, and therefore in differences in local control or complications, but they may also vary in treatment cost and time. Proton therapy should be actually very useful for the treatment of these tumors. Given the physical properties of protons (Bragg peak), this technic may be a suitable approach to reduce the risk of radiation-induced toxicity, particularly in optic pathway, cochlea and brain normal structures. But at two times the cost of IMRT, clinical data to prove proton’s benefit over photon radiation is essential to moving the technology forward. Our goal is to describe IMRT, PT; to report the outcomes of 91 adult patients treated with PT.
L’auteur n’a pas transmis de déclaration de conflit d’intérêt.