Commentary: intracystic bleomycin for cystic craniopharyngiomas in children (abridged republication of cochrane systematic review).

memory, social and emotional function, and school difficulties in patients receiving proton radiation after several aggressive surgeries compared with those treated with subtotal resection followed by proton therapy. This again speaks to the potential benefit of limited surgery and radiation for patients with tumors not amenable to gross total resection. We advocate for a “maximal safe resection,” asking neurosurgeons to back out if they think they are even getting close to causing hypothalamic or pituitary damage and allowing patients to proceed to radiation, which still can effectively control these tumors. Ideally, pediatric patients who require radiation for craniopharyngiomas should be referred to a proton therapy center to limit late sequelae if at all possible.