• Ajay Niranjan, Hideyuki Kano, David Mathieu, Douglas Kondziolka, John C Flickinger, and L Dade Lunsford.
• Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. niranjana@upmc.edu
• Int. J. Radiat. Oncol. Biol. Phys. 2010 Sep 1; 78 (1): 64-71.

PurposeTo analyze the outcomes of gamma knife stereotactic radiosurgery (SRS) for residual or recurrent craniopharyngiomas and evaluate the factors that optimized the tumor control rates.Methods And MaterialsA total of 46 patients with craniopharyngiomas underwent 51 SRS procedures at University of Pittsburgh between 1988 and 2007. The median tumor volume was 1.0 cm(3) (range, 0.07-8.0). The median prescription dose delivered to the tumor margin was 13.0 Gy (range, 9-20). The median maximal dose was 26.0 Gy (range, 20-50). The mean follow-up time was 62.2 months (range, 12-232).ResultsThe overall survival rate after SRS was 97.1% at 5 years. The 3- and 5-year progression-free survival rates (solid tumor control) were both 91.6%. The overall local control rate (for both solid tumor and cyst control) was 91%, 81%, and 68% at 1, 3, and 5 years, respectively. No patients with normal pituitary function developed hypopopituitarism after SRS. Two patients developed homonymous hemianopsia owing to tumor progression after SRS. Among the factors examined, complete radiosurgical coverage was a significant favorable prognostic factor.ConclusionSRS is a safe and effective minimally invasive option for the management of residual or recurrent craniopharyngiomas. Complete radiosurgical coverage of the tumor was associated with better tumor control.Copyright (c) 2010 Elsevier Inc. All rights reserved.

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