Intratumoral therapy with bleomycin for cystic craniopharyngiomas in children

Pediatr Neurosurg. 2000 Oct;33(4):211-8. doi: 10.1159/000055955.

Abstract

Surgical removal of cystic craniopharyngiomas in children is associated with significant operative morbidity and recurrence rates. The purpose of this study was to review our experience with a less invasive therapy, namely, intratumoral bleomycin, in the treatment of predominantly cystic craniopharyngiomas. All children with craniopharyngiomas treated at a tertiary care pediatric neurosurgical center since 1994, when bleomycin was first used, were reviewed retrospectively. Seven patients received intratumoral bleomycin therapy. Patients received 2-5 mg bleomycin per dose, 3 times per week, for 3-5 weeks as an initial course. Mean follow-up of these patients was 3 years. In 4 patients, treatment resulted in a significant decrease (>50%) in tumor size, which has remained stable. Two patients' tumors progressed and underwent resection, and 1 patient had surgical removal because of persistent headaches, although no growth of residual tumor had been noted. One patient developed peritumoral edema as a result of bleomycin therapy. Intratumoral bleomycin is a useful alternative therapy for cystic craniopharyngiomas, and may control tumor growth and delay potentially harmful resection and/or radiotherapy in young children.

MeSH terms

  • Antibiotics, Antineoplastic / administration & dosage*
  • Bleomycin / administration & dosage*
  • Brain Edema
  • Child, Preschool
  • Craniopharyngioma / drug therapy*
  • Craniopharyngioma / pathology
  • Cysts / drug therapy
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Infant
  • Injections, Intralesional
  • Male
  • Pituitary Neoplasms / drug therapy*
  • Pituitary Neoplasms / pathology
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antibiotics, Antineoplastic
  • Bleomycin