Late Effects in Patients Treated for Childhood Craniopharyngioma
Quality-of-life issues are important in this group of patients and are difficult to generalize because of the various treatment modalities.
Late effects of treatment for childhood craniopharyngioma include the following:
- Behavioral issues and memory deficits. Although intelligence quotient is usually maintained, behavioral issues and memory deficits attributed to the frontal lobe and hypothalamus commonly occur. Patients with hypothalamic involvement showed impairment in memory and executive functioning.
- Vision loss.
- Endocrine abnormalities. Endocrine abnormalities result in the almost universal need for life-long endocrine replacement with multiple pituitary hormones.[3-5][Level of evidence: 3iiiC] A report indicated that adults treated with long-term growth hormone replacement after childhood onset craniopharyngioma involving the hypothalamus were at increased risk of cardiovascular disease.
- Obesity, which can be life-threatening.
- Vasculopathies and subsequent neoplasms. Vasculopathies and subsequent neoplasms may result from local irradiation.
Refer to the PDQ summary on Late Effects of Treatment for Childhood Cancer for specific information about the incidence, type, and monitoring of late effects in childhood and adolescent cancer survivors.
- Winkfield KM, Tsai HK, Yao X, et al.: Long-term clinical outcomes following treatment of childhood craniopharyngioma. Pediatr Blood Cancer 56 (7): 1120-6, 2011. [PUBMED Abstract]
- Özyurt J, Thiel CM, Lorenzen A, et al.: Neuropsychological outcome in patients with childhood craniopharyngioma and hypothalamic involvement. J Pediatr 164 (4): 876-881.e4, 2014. [PUBMED Abstract]
- Vinchon M, Weill J, Delestret I, et al.: Craniopharyngioma and hypothalamic obesity in children. Childs Nerv Syst 25 (3): 347-52, 2009. [PUBMED Abstract]
- Dolson EP, Conklin HM, Li C, et al.: Predicting behavioral problems in craniopharyngioma survivors after conformal radiation therapy. Pediatr Blood Cancer 52 (7): 860-4, 2009. [PUBMED Abstract]
- Kawamata T, Amano K, Aihara Y, et al.: Optimal treatment strategy for craniopharyngiomas based on long-term functional outcomes of recent and past treatment modalities. Neurosurg Rev 33 (1): 71-81, 2010. [PUBMED Abstract]
- Holmer H, Ekman B, Björk J, et al.: Hypothalamic involvement predicts cardiovascular risk in adults with childhood onset craniopharyngioma on long-term GH therapy. Eur J Endocrinol 161 (5): 671-9, 2009. [PUBMED Abstract]
- Elowe-Gruau E, Beltrand J, Brauner R, et al.: Childhood craniopharyngioma: hypothalamus-sparing surgery decreases the risk of obesity. J Clin Endocrinol Metab 98 (6): 2376-82, 2013. [PUBMED Abstract]
- Kiehna EN, Merchant TE: Radiation therapy for pediatric craniopharyngioma. Neurosurg Focus 28 (4): E10, 2010. [PUBMED Abstract]