Craniopharyngioma medical therapy: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 4: Line 4:


==Overview==
==Overview==
The predominant therapy for craniopharyngioma is surgical resection. Adjunctive [[chemotherapy]] and [[radiation]] may be required. Subcutaneous pegylated [[interferon]] alpha-2B has been used to treat cystic recurrences. It can also be treated with intracavitary instillation of radioactive P-32, [[bleomycin]] or [[interferon-alpha]] via [[stereotactic]] delivery or placement of an Ommaya catheter. [[Paclitaxel]] and [[carboplatin]] have shown to prevent recurrence of malignant craniopharyngiomas.Intracavitary bleomycin reduces cyst size and toughens and thickens the cyst wall, thereby facilitating surgical excision of a cyst membrane that otherwise might fragment at the time of open craniotomy. Reports of intracystic bleomycin use are limited. Other agents like interferon alpha are being tested in recent days.
The predominant therapy for craniopharyngioma is [[Resection|surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required. Subcutaneous [[Pegylated interferon-alpha-2a|pegylated]] [[interferon]] [[Alpha-2B adrenergic receptor|alpha-2B]] has been used to treat [[Cyst|cystic]] recurrences. It can also be treated with intracavitary instillation of [[Radioactive isotopes|radioactive P-32,]] [[bleomycin]] or [[interferon-alpha]] via [[stereotactic]] delivery or placement of an [[Ommaya reservoir|Ommaya catheter]]. [[Paclitaxel]] and [[carboplatin]] have shown to prevent recurrence of malignant craniopharyngiomas. [[Bleomycin|Intracavitary bleomycin]] reduces cyst size and toughens and thickens the cyst wall, thereby facilitating surgical excision of a cyst membrane that otherwise might fragment at the time of open [[craniotomy]]. Reports of intracystic bleomycin use are limited. Other agents like [[Interferon type I|interferon alpha]] are being tested in recent days.


==Medical Therapy==
==Medical Therapy ==
*Although the mainstay of therapy for craniopharyngioma is surgery with or without radiation, there are certain indications for medical therapy as well, mostly in treating recurrent tumors.   
*The mainstay of therapy for craniopharyngioma is surgery with or without [[Radiation therapy|radiation]]. 
*Although systemic therapy is generally not utilized, it has been shown that the use of '''subcutaneous pegylated [[interferon]] alpha-2b''' to manage ''cystic recurrences'' can result in durable responses.<ref>Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc</ref>
*There are certain [[Indications and usage|indications]] for medical therapy mostly in treating recurrent tumors.   
*The chemotherapy drugs [[Paclitaxel]] and [[Carboplatin]] have shown a clinical significance in increasing the survival rate in patients who've had gross total resections of their malignant tumors.
*The use of subcutaneous [[Interferon-alpha|pegylated interferon alpha-2b]] to manage [[Cyst|cystic]] recurrences can result in durable responses.<ref>Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc</ref>
*''Cystic recurrences'' may be treated with intracavitary instillation of varying agents via [[stereotactic]] delivery or placement of an Ommaya catheter. These agents have included radioactive P-32 or other radioactive compounds, [[bleomycin]] or [[interferon-alpha]]. These strategies have been found to be useful in certain cases, and a low risk of complications has been reported. However, none of these approaches have shown efficacy against solid portions of the tumor.<ref>Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc</ref>
*The [[Chemotherapy|chemotherapy drugs]] [[Paclitaxel]] and [[Carboplatin]] have shown a clinical significance in increasing the survival rate.
*The following is an example of a national and/or institutional ''phase II'' clinical trial that is currently being conducted. '''PBTC-039''' (NCT01964300) (''Peginterferon Alpha-2b'') in treating younger patients with craniopharyngioma that is recurrent or cannot be removed by surgery.<ref>Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc</ref>
*Cystic recurrences may be treated with intracavitary instillation of varying agents via [[stereotactic]] delivery or placement of an Ommaya catheter.  
*Stereotactic agents have included radioactive P-32 or other radioactive compounds, [[bleomycin]] or [[interferon-alpha]].  
*None of these approaches have shown efficacy against solid portions of the tumor.<ref>Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc</ref> <ref>Rx of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc</ref>


==References==
==References==

Revision as of 14:13, 13 February 2019

Craniopharyngioma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Craniopharyngioma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Treatment

Medical Therapy

Surgery

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Craniopharyngioma medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Craniopharyngioma medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Craniopharyngioma medical therapy

CDC on Craniopharyngioma medical therapy

Craniopharyngioma medical therapy in the news

Blogs on Craniopharyngioma medical therapy

Directions to Hospitals Treating Craniopharyngioma

Risk calculators and risk factors for Craniopharyngioma medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]

Overview

The predominant therapy for craniopharyngioma is surgical resection. Adjunctive chemotherapy and radiation may be required. Subcutaneous pegylated interferon alpha-2B has been used to treat cystic recurrences. It can also be treated with intracavitary instillation of radioactive P-32, bleomycin or interferon-alpha via stereotactic delivery or placement of an Ommaya catheter. Paclitaxel and carboplatin have shown to prevent recurrence of malignant craniopharyngiomas. Intracavitary bleomycin reduces cyst size and toughens and thickens the cyst wall, thereby facilitating surgical excision of a cyst membrane that otherwise might fragment at the time of open craniotomy. Reports of intracystic bleomycin use are limited. Other agents like interferon alpha are being tested in recent days.

Medical Therapy

  • The mainstay of therapy for craniopharyngioma is surgery with or without radiation.
  • There are certain indications for medical therapy mostly in treating recurrent tumors.
  • The use of subcutaneous pegylated interferon alpha-2b to manage cystic recurrences can result in durable responses.[1]
  • The chemotherapy drugs Paclitaxel and Carboplatin have shown a clinical significance in increasing the survival rate.
  • Cystic recurrences may be treated with intracavitary instillation of varying agents via stereotactic delivery or placement of an Ommaya catheter.
  • Stereotactic agents have included radioactive P-32 or other radioactive compounds, bleomycin or interferon-alpha.
  • None of these approaches have shown efficacy against solid portions of the tumor.[2] [3]

References


Template:WikiDoc Sources