Proton beam therapy for craniopharyngioma: a systematic review and meta-analysis.

in Radiation oncology (London, England) by Zhi Li, Qingyong Li, Haidong Tian, Maoqing Wang, Ru Lin, Juan Bai, Dandan Wang, Meng Dong

TLDR

  • The study found that proton beam therapy (PBT) is a good treatment for craniopharyngioma, a rare tumor in the brain. The study looked at many studies and found that PBT was effective and safe, with only mild side effects. The study also looked at how long patients lived and how well their tumors were controlled. The study suggests that PBT is a good option for treating craniopharyngioma, but more research is needed to see how well it works in different situations.

Abstract

Craniopharyngioma is a rare and slow-growing benign sellar or parasellar epithelial tumor. The number of patients receiving proton beam therapy (PBT) has increased. This study aimed to systematically evaluate and analyze the comprehensive evidence regarding the safety and efficacy of PBT for craniopharyngioma. We searched four databases: the Cochrane Library, PubMed, Embase, and Web of Science. The period was from their inception to February 16, 2024. Two researchers independently screened the literature and extracted data. Among 486 candidate articles, eight studies were included in our study. Exactly 393 patients with craniopharyngioma underwent PBT in these studies. These studies reported data on survival and toxicity. The median sample size was 42.5 patients. The median age was 9.1-37 years; the female proportion was 48.9%, and the median follow-up time was 29-91.4 months. All patients were treated once daily, five times a week, with a fraction of 1.8 Gy (RBE) per session. The median total dose was 54.0 Gy (RBE). The local control rates at 3 and 5 years in these studies were 99% and 93%, respectively. The overall survival rates at 3 and 5 years in these studies were both 100%. The incidence of acute and late toxicities was mainly grade 1-2. The main late toxicities included vascular and visual toxicities, hypothalamic obesity, endocrinopathy, and panhypopituitarism. PBT for craniopharyngioma, especially in children and adolescents, has shown impressive local control and acceptable acute and late toxicities.

Overview

  • The study aims to evaluate the safety and efficacy of proton beam therapy (PBT) for craniopharyngioma.
  • The methodology used for the experiment includes searching four databases for relevant studies and extracting data on survival and toxicity.
  • The primary objective of the study is to report the local control and overall survival rates at 3 and 5 years, as well as the incidence of acute and late toxicities in patients undergoing PBT for craniopharyngioma.

Comparative Analysis & Findings

  • The study found that the local control rates at 3 and 5 years were 99% and 93%, respectively, and the overall survival rates at 3 and 5 years were both 100%.

Implications and Future Directions

  • The study suggests that PBT for craniopharyngioma is an effective and safe treatment option with acceptable acute and late toxicities.
  • Future research should focus on expanding the sample size and including more patients with different age groups and tumor characteristics to further evaluate the safety and efficacy of PBT for craniopharyngioma.
  • Additional studies are needed to investigate the long-term effects of PBT on quality of life and cognitive function in patients with craniopharyngioma.
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