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Introduction <p>Craniopharyngioma is histologically benign yet locally aggressive, with frequent recurrence. Long-term multicenter outcomes after stereotactic radiosurgery (SRS) remain incompletely defined.</p> Methods <p>We performed a retrospective multi-institutional cohort study through the International Radiosurgery Research Foundation including 296 patients from 13 centers. Median age at first SRS was 33.6 years. Median tumor volume was 1.32&#xa0;cm³ and median margin dose was 12.0&#xa0;Gy. The primary endpoint was local control (LC); secondary endpoints were progression-free survival (PFS) and overall survival (OS). Kaplan–Meier methods estimated outcomes, and Cox proportional hazards models evaluated predictors of LC.</p> Results <p>Actuarial 1-, 5-, and 10-year LC was 93.5%, 76.2%, and 70.1%. Actuarial 1-, 5-, and 10-year OS was 98.2%, 93.6%, and 85.2%, and PFS was 92.4%, 73.6%, and 64.8%. Mixed solid–cystic phenotype had worse LC than non-mixed tumors (log-rank <i>p</i> = 0.025); non-mixed phenotype remained independently associated with improved LC (HR 0.53, <i>p</i> = 0.026). Visual fields improved in 10%, were unchanged in 86%, and deteriorated in 4%; visual acuity improved in 6%, was unchanged in 91%, and worsened in 3%. Ten-year freedom from endocrine deterioration was 96.7%. Diabetes insipidus improved in 6.3%, worsened in 0.5% and other pituitary dysfunction was noted in 2.6%,</p> Conclusion <p>In this international multi-institutional experience, SRS achieved durable long-term control with favorable survival and low incidence of visual and endocrinologic dysfunction. Mixed phenotype was an important determinant of LC.</p> Clinical trial number <p>Not applicable.</p>

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Stereotactic radiosurgery offers long-term tumor control for craniopharyngioma: a multi-institutional analysis of clinical and imaging outcomes from the International Radiosurgery Research Foundation (IRRF)

  • 期刊论文

  • 发表日期：

    2026年8月3日

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  • Ajay Niranjan,
  • Jheremy S. Reyes,
  • Constantinos G. Hadjipanayis,
  • Kenneth Bernstein,
  • Herwin Speckter,
  • Ivan Gonzalez,
  • Tomas Chytka,
  • Roman Liscak,
  • Greg N. Bowden,
  • Takuma Sumi,
  • Kentaro Narita,
  • Hideyuki Kano,
  • Nuria Martínez-Moreno,
  • Roberto Martínez-Álvarez,
  • Piero Picozzi,
  • Andrea Franzini,
  • Manjul Tripathi,
  • Ashutosh Rai,
  • Narendra Kumar,
  • Keiss Douri,
  • David Mathieu,
  • Antonio Dono,
  • Christian Amezquita-Contreras,
  • Angel I. Blanco,
  • Yoshua Esquenazi,
  • Salem M. Tos,
  • Georgios Mantziaris,
  • Selcuk Peker,
  • Yavuz Samanci,
  • Ali Haluk Duzkalir,
  • Ying Meng,
  • Jason P. Sheehan,
  • Douglas Kondziolka,
  • L. Dade Lunsford

摘要

Introduction

Craniopharyngioma is histologically benign yet locally aggressive, with frequent recurrence. Long-term multicenter outcomes after stereotactic radiosurgery (SRS) remain incompletely defined.

Methods

We performed a retrospective multi-institutional cohort study through the International Radiosurgery Research Foundation including 296 patients from 13 centers. Median age at first SRS was 33.6 years. Median tumor volume was 1.32 cm³ and median margin dose was 12.0 Gy. The primary endpoint was local control (LC); secondary endpoints were progression-free survival (PFS) and overall survival (OS). Kaplan–Meier methods estimated outcomes, and Cox proportional hazards models evaluated predictors of LC.

Results

Actuarial 1-, 5-, and 10-year LC was 93.5%, 76.2%, and 70.1%. Actuarial 1-, 5-, and 10-year OS was 98.2%, 93.6%, and 85.2%, and PFS was 92.4%, 73.6%, and 64.8%. Mixed solid–cystic phenotype had worse LC than non-mixed tumors (log-rank p = 0.025); non-mixed phenotype remained independently associated with improved LC (HR 0.53, p = 0.026). Visual fields improved in 10%, were unchanged in 86%, and deteriorated in 4%; visual acuity improved in 6%, was unchanged in 91%, and worsened in 3%. Ten-year freedom from endocrine deterioration was 96.7%. Diabetes insipidus improved in 6.3%, worsened in 0.5% and other pituitary dysfunction was noted in 2.6%,

Conclusion

In this international multi-institutional experience, SRS achieved durable long-term control with favorable survival and low incidence of visual and endocrinologic dysfunction. Mixed phenotype was an important determinant of LC.

Clinical trial number

Not applicable.