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).

Authors

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

Published in

Journal of neuro-oncology. Volume 179. Issue 1. Aug 03, 2026. Epub Aug 03, 2026.

Abstract

Craniopharyngioma is histologically benign yet locally aggressive, with frequent recurrence. Long-term multicenter outcomes after stereotactic radiosurgery (SRS) remain incompletely defined.
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.
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.
Not applicable.

PMID:
42545447
Bibliographic data and abstract were imported from PubMed on 03 Aug 2026.

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