ESPE Abstracts (2019) 92 P1-398

Postoperative Quality of Life in Children and Adolescents with Craniopharyngioma – Results of the Prospective Multicenter Trial KRANIOPHARYNGEOM 2007

Maria Eveslage1, Gabriele Calaminus2, Monika Warmuth-Metz3, Rolf-Dieter Kortmann4, Fabian Pohl5, Beate Timmermann6, Martin Schuhmann7, Jörg Flitsch8, Andreas Faldum1, Hermann L. Müller9

1Institute of Biostatistics and Clinical Research, University Münster, Muenster, Germany. 2Department of Pediatric Hematology and Oncology, University Childrens Hospital, Münster, Germany. 3Department of Neuroradiology, University Hospital, Würzburg, Germany. 4Department of Radiooncology, University Hospital, Leipzig, Germany. 5Department of Radiooncology, University Hospital, Regensburg, Germany. 6Westdeutsches Protonenzentrum (WPE), University Hospital, Essen, Germany. 7Department of Neurosurgery, University Hospital, Tübingen, Germany. 8Department of Neurosurgery, University Hospital (UKE), Hamburg, Germany. 9Department of Pediatric Hematology and Oncology, University Childrens Hospital, Oldenburg, Germany

Background: Craniopharyngioma is an embryonic tumor of low-grade malignancy. Children and adolescents with this diagnosis are analyzed concerning quality of life (QoL) and (progression-free) survival within the project KRANIOPHARYNGEOM 2007.

Methods: The prospective, multi-center project consists of a randomized, unblinded substudy with adaptive design and an observational study. The randomized substudy for incompletely resected patients compares direct postsurgical radiation with radiation at progression. Endpoint is self-assessment of QoL measured by PEDQOL. In explorative analyses, the influence of additional factors was analyzed using linear mixed models.

Results: In the interim analysis of the randomized substudy according to the intention-to-treat approach only marginal differences concerning QoL between the two treatment groups were observed (n=24). The explorative analyses (n=131) show that ant-/ and posterior preoperative hypothalamic involvement and postoperative hypothalamic lesions are associated with decreased QoL. After complete resection, the QoL is lower than with incomplete resection. Radiation, which is often performed due to progression after incomplete resection, is associated with reduced quality of life.

Conclusion: In order to achieve best QoL for children and adolescents with craniopharyngioma, hypothalamus-sparing therapeutic approaches are recommended. Based on the current data, it is not possible to recommend the optimal time for radiotherapy after incomplete resection with regard to QoL.