KEY POINTS
- This single-center retrospective study included 34 patients with histologically confirmed papillary craniopharyngioma treated with Gamma Knife radiosurgery at Beijing Tiantan Hospital between 2002 and 2025 after prior surgery for residual or recurrent disease.
- The median marginal dose was 12 Gy, delivered to a median tumor volume of 1.10 cm³; 4 patients (11.8%) received planned fractionated radiosurgery because of proximity to critical structures.
- With median clinical follow-up of 54.10 months, complete response occurred in 5.88%, partial response in 23.53%, stable disease in 41.18%, and progressive disease in 29.41%.
- The 1-, 3-, and 5-year progression-free survival rates were 91.18%, 82.35%, and 73.53%, respectively; overall survival was 94.12%.
- Exploratory multivariable analysis suggested possible associations between progression and tumor volume (hazard ratio 3.864, p = 0.061) or preoperative hypogonadism (hazard ratio 3.942, p = 0.058), but these were not statistically significant and were underpowered.
CLINICAL TAKEAWAY
Gamma Knife radiosurgery appears to be a reasonable postoperative option for selected patients with residual or recurrent papillary craniopharyngioma, particularly when repeat surgery is undesirable. The durability of control is clinically relevant for such a rare tumor, but the evidence remains limited by retrospective design, 34 patients, only 10 progression events, non-standardized functional assessment, incomplete radiological follow-up, and treatment-era effects across more than two decades. This is worth attention as a rare-disease series, not a definitive treatment standard.