Executive summary

Published in The Lancet, Oncology, this study reported outcomes of 94 craniopharyngioma patients treated with proton therapy at St Jude, Memphis and UFHPT, Jacksonville. Outcomes were then compared with a historical cohort treated with photon therapy. With a median follow-up time of 7.62 years for the whole cohort, this study reported PFS 96.8% and OS 100% at 3 years. At 5 years, necrosis had occurred in two (2%) of 94 patients, severe vasculopathy in four (4%), and permanent neurological conditions in three (3%); decline in vision from normal to abnormal occurred in four (7%) of 54 patients with normal vision at baseline. The most common grade 3-4 adverse events were headache (six [6%] of 94 patients), seizure (five [5%]), and vascular disorders (six [6%]). The authors concluded that proton therapy did not improve survival outcomes in pediatric and adolescent patients with craniopharyngioma, and severe complication rates were similar. However, cognitive outcomes with proton therapy were improved over photon therapy.