Intracystic Therapy

Intracystic therapies include peginterferon alpha, radioactive phosphorus P 32 (32P) or other compounds,[46-48]; [49][Level of evidence B4] and interferon-alpha (which is no longer commercially available).[50]; [51][Level of evidence C1]; [52][Level of evidence C2] Bleomycin has previously been used.[53]; [54][Level of evidence C2]

A systematic review of publications on the treatment of cystic craniopharyngiomas with radioisotope brachytherapy from 2010 to 2021 identified 66 pediatric patients (N = 228).[55] With a minimum follow-up of 5 years, partial and complete responses were achieved in 89% of children with purely cystic lesions, compared with 58% of children with nonexclusively cystic lesions. Visual improvement was achieved in 64% of the patients with purely cystic lesions, and endocrine improvement was achieved in 20% of these patients. The observed progression rate was 3% for patients with purely cystic lesions. Treatment with intracystic brachytherapy, most commonly using 32P and yttrium Y 90, can be considered for patients with purely cystic craniopharyngiomas.