Fractionated proton radiation treatment for pediatric craniopharyngioma: preliminary report.

This retrospective preliminary review evaluated the efficacy and toxicity of fractionated proton radiotherapy in the management of pediatric craniopharyngioma.Sixteen patients, aged 7-34 years, were treated with proton-beam radiation. All had undergone at least one tumor resection. Seven patients underwent repeat resection for recurrence; one had previous x-ray radiotherapy. A daily dose of 1.8 cobalt gray equivalent was used to give a total dose in the range of 50.4-59.4 cobalt gray equivalent.Local control was achieved in 14 of 15 patients. Twelve of 15 patients survived. There were few acute side effects. Long-term complications included newly diagnosed panhypopituitarism, a cerebrovascular accident from which the patient fully recovered, and an out-of-proton-field meningioma in the single patient who received previous radiotherapy.Fractionated proton radiotherapy is an effective treatment for children with craniopharyngioma. Longer follow-up is needed to evaluate late complications.