Initial Gamma Knife radiosurgery for nonfunctioning pituitary adenomas: results from a 26-year experience
- 11 March 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Endocrine
- Vol. 68 (2), 399-410
- https://doi.org/10.1007/s12020-020-02260-1
Abstract
Objective The aim of this study was to evaluate the long-term outcomes of initial Gamma Knife radiosurgery (GKRS) for patients with nonfunctioning pituitary adenomas (NFPAs). Design and methods This was a single-center retrospective study. Eighty-one patients with NFPAs undergoing initial GKRS were enrolled. The median age was 44.9 years (range, 7.2–75.5 years). The median tumor volume was 2.3 cm3 (range, 0.1–31.3 cm3), and the median tumor margin dose was 13.0 Gy (range, 8–22 Gy). Results Tumor shrunk in 63 patients (77.8%), remained stable in 9 (11.1%), treatment failure in 9 (11.1%) during a median follow-up of 67.1 months (range, 11.5–263.9 months). The tumor control rates were 100%, 99%, 95%, and 84%, at 1, 3, 5, and 10 years, respectively. In multivariate analysis, tumor volume (≥4 cm3) and margin dose (p = 0.040, and HR = 9.643, 95% CI = 1.108–83.927, p = 0.040, respectively). New apoplexy occurred in seven patients (8.6%) after GKRS with a median time of 39.9 months (range, 11.9–166.8 months). In multivariate analysis, tumor volume (≥10 cm3) was a significant risk factor (HR = 10.642, 95% CI = 2.121–53.398, p = 0.004). New hypopituitarism occurred in 14 patients (17.3%). No factors were associated with new hypopituitarism. Four patients (4.9%) developed new or worsening visual dysfunction. No new cranial neuropathy was noted. Conclusions In this study, initial GKRS can provide a high tumor control rate, as well as a low incidence rate of complications in NFPAs. GKRS may be an alternative initial treatment for selected NFPAs.Funding Information
- National Natural Science Foundation of China (81800682)
- Medical Science and Technology Research Fund Project of Guangdong (A2018443, 2017YFC0113700)
- Medical and Health Project of Guangdong
This publication has 41 references indexed in Scilit:
- Long-Term Follow-Up Studies of Gamma Knife Radiosurgery for Postsurgical Nonfunctioning Pituitary AdenomasWorld Neurosurgery, 2019
- Microsurgical therapy of pituitary adenomasEndocrine, 2017
- Clinical and Radiologic Outcome of Gamma Knife Radiosurgery on Nonfunctioning Pituitary AdenomasJournal of Neurological Surgery Part B: Skull Base, 2015
- Long-term Results of Endonasal Endoscopic Transsphenoidal Resection of Nonfunctioning Pituitary MacroadenomasNeurosurgery, 2015
- Adjuvant Gamma Knife radiosurgery in non-functioning pituitary adenomas; low risk of long-term complications in selected patientsPituitary, 2009
- Long-term recurrence and mortality after surgery and adjuvant radiotherapy for nonfunctional pituitary adenomasJournal of Neurosurgery, 2008
- Non-functioning pituitary adenoma database: a useful resource to improve the clinical management of pituitary tumorsActa Endocrinologica, 2006
- The Endoscopic versus the Traditional Approach in Pituitary SurgeryNeuroendocrinology, 2006
- Radiosurgery and the prevention of regrowth of incompletely removed nonfunctioning pituitary adenomasJournal of Neurosurgery, 2005
- The Role of Radiation Therapy after Surgical Resection of Nonfunctional Pituitary MacroadenomasNeurosurgery, 2004