A Phase II Trial of Limited Surgery and Proton Therapy for Craniopharyngioma or Observation After Radical Resection

The goal of this study is to determine the feasibility and safety of treating patients with a brain tumor known as craniopharyngioma with limited surgery and a 5mm clinical target volume margin in combination with proton therapy. Proton therapy will be indicated for patients with diagnosed craniopharyngioma who are not treated with radical surgery (gross-total resection). Irradiated patients will undergo a series of evaluations designed to evaluate the effects of proton therapy. Similar evaluations will be performed on patients treated with radical surgery. Proton therapy will include 30 treatment fractions administered 5 days per week. Weekly imaging will be a requirement to monitor for cyst expansion and target volume deformation.

Inclusion Criteria: * Craniopharyngioma diagnosed by histology, cytology or neuroimaging. * Patients ages 0-21 years at the time of diagnosis. Exclusion Criteria * Prior history of fractionated radiation therapy. * Prior treatment with intracystic P-32, intracystic bleomycin or radiosurgery. * Pregnant females are excluded. Radiation has teratogenic or abortifacient effects.