Craniopharyngioma is locally aggressive and treatment is always indicated.
Surgery is the initial treatment although there is debate as to the extent:

  • Extensive surgery may be curative and avoid the need for radiotherapy; however this may not always be feasible and may lead to increased toxicity
  • Local surgery is less invasive but patients require radiotherapy; this should be avoided in children where possible

Radiotherapy is used for primary inoperable tumours or when surgery is not able to completely remove the tumour. Dose is 54 Gy in 30 fractions (1.8 Gy/fraction), preferably using stereotactic fractionated radiotherapy due to the proximity to the optic chiasm.