Imaging-guided Intracavitary Irradiation And Surgery for Craniopharyngiomas: A Comparative Study

Objective: The patients with craniopharyngioma is hard to choose the variant treatment method. The aim of this study was to compared imaging-guided intracavitary irradiation and surgical approaches for craniopharyngioma. Method: A total of 309 patients with craniopharyngiomas from January 1986 to April 2017 at our hospital was retrospectively analyzed. In them, 233 patents were underwent microsurgical resection via various approaches and 76 patients were underwent intracavitary irradiation via Ommaya capsule. Both of patients were guided by preoperative contrast computed tomography (CT) and magnetic resonance imaging (MRI). During follow-ups, they were monitored for residual or recurrent tumor by CT and MRI. Result: According preoperative CT and MRI, the intracavitary irradiation or different surgical approaches were selected. Compared with the resection group, the intracavitary irradiation method had the advantages of short operating time, short hospitalized time and less complications. but more residuals and relapses. After the microsurgical resection guided by CT or MR neuronavigation, there were 94 cases of residual tumor and 56 cases of relapse. The removals of lesions were total (n = 139, 59.7%), subtotal (n = 78, 33.5%) and partial (n = 16, 6.9%). And 143 cases had an intact preservation of pituitary stalk, which partially preserved in 33 patients, severed in 27 cases, and unidentified in 31 cases during surgery. Conclusion: Selection of a personalized approach tailored to the individual patient according to preoperative imaging morphological characteristics is essential for successful microsurgery of craniopharyngioma.