The role of fractionated radiotherapy and radiosurgery in the management of patients with craniopharyngioma

Neurosurg Rev. 2009 Apr;32(2):125-32; discussion 132. doi: 10.1007/s10143-009-0186-4. Epub 2009 Jan 23.


The optimal management of craniopharyngiomas remains controversial. The first-line treatment usually consists of surgical resection. Complete tumor removal provides a high rate of long-term control; however, aggressive surgery is associated with significant incidence of complications. Radiotherapy (RT) is currently used in patients after limited surgery and achieves excellent long-term tumor control. Stereotactic radiotherapy, both in the form of radiosurgery (RS) or fractionated stereotactic radiotherapy (FSRT), has been developed as a more accurate technique of irradiation with more precise tumor localization and consequently a reduction in the volume of normal brain irradiated to high radiation doses. We provide a review of published data on outcome of conventional fractionated RT and modern radiation techniques. FSRT is a suitable treatment technique for all sizes of craniopharyngiomas, and efficacy is comparable to conventional RT. Single-fraction stereotactic radiosurgery is usually delivered to small tumors away from critical structures. Longer follow-up is necessary to confirm the excellent tumor control and the potential reduction of long-term radiation toxicity.

Publication types

  • Review

MeSH terms

  • Craniopharyngioma / radiotherapy*
  • Craniopharyngioma / surgery*
  • Dose Fractionation, Radiation*
  • Humans
  • Pituitary Neoplasms / radiotherapy*
  • Pituitary Neoplasms / surgery*
  • Radiosurgery / adverse effects
  • Radiosurgery / methods*
  • Time Factors
  • Treatment Outcome