Proton Therapy for Craniopharyngioma - An Early Report from a Single European Centre.

AIMS: Proton beam therapy (PBT) is being increasingly used for craniopharyngioma. We describe our early outcome of patients treated with PBT. MATERIALS AND METHODS: Between August 2013 and July 2016, 18 patients with craniopharyngiomas were treated with 54 Cobalt Gray Equivalent (CGE) in 30 fractions over 6 weeks at our centre. The early outcome of 16 patients included in a registry study was analysed. Radiological response was assessed by RECIST criteria and the disease- and treatment-related toxicities were scored according to the CTCAE 4.0. RESULTS: All patients are alive at a median follow-up of 32.6 months (range 9.2-70.6 months) from initial diagnosis. The median age at PBT was 10.2 years (range 5.4-46.9 years). One patient progressed 8.7 months after PBT and subsequently had complete resection of the tumour. At a median follow-up of 18.4 months after PBT, five patients remained in complete remission, four in partial remission and seven with stable disease. The most common adverse effects during PBT were grade 1 (cutaneous in seven patients and fatigue in six patients). There were no treatment-related grade 3 toxicities. CONCLUSIONS: Our early results are encouraging and comparable with the limited literature on PBT for craniopharyngioma.

Renovascular and tubular effects of neuropeptide Y are discriminated by PP56 (D-myo-inositol 1,2,6-triphosphate) in anaesthetized rats.

Systemic infusion of neuropeptide Y (NPY; 1 microg kg-1 min-1) for 120 min rapidly reduced renal blood flow and increased mean arterial pressure and renovascular resistance and, at later time points (> 30 min), enhanced diuresis, natriuresis and calciuresis in anaesthetized rats. Infusion of the reported NPY antagonist PP56 (D-myo-inositol 1,2,6-triphosphate, 333 mg kg-1 min-1) slightly but significantly enhanced renal blood flow and reduced renovascular resistance over the course of the infusion period. Infusion of PP56 together with NPY (starting 30 min prior to the NPY infusion) significantly inhibited NPY-induced alterations of mean arterial pressure, renal blood flow and renovascular resistance. Coinfusion of PP56 also attenuated the renovascular effects of bolus injections of NPY (0.1-10 microg/kg) but at the highest NPY dose the antagonistic effect of PP56 could partially be overcome. In contrast to the antagonism of the vascular NPY effects, infusion of PP56 did not significantly affect NPY-induced enhancements of diuresis, natriuresis and calciuresis. Thus, PP56 is a surmountable antagonist of vascular but not tubular NPY effects. We conclude that tubular NPY effects occur largely independently of alterations of renal haemodynamics.