The efficacy of fractionated radiotherapy and stereotactic radiosurgery for pituitary adenomas
Open Access
- 28 June 2007
- Vol. 110 (4), 854-860
- https://doi.org/10.1002/cncr.22860
Abstract
BACKGROUND. The objective of this retrospective cohort study was to define the efficacy and safety of fractionated radiotherapy (FRT) and stereotactic radiosurgery (SRS) for the treatment of patients with pituitary adenoma. METHODS. Between January 1995 and April 2006, 125 consecutive patients with pituitary adenomas (54 hormone‐secreting adenomas and 71 nonsecretory adenomas) received FRT or underwent SRS. Sixty‐four patients received FRT, for which the mean total dose was 50.4 grays (Gy) (range, 48–54 Gy), and 61 patients underwent gamma‐knife SRS with mean marginal dose of 25.1 Gy (range, 9–30 Gy). RESULTS. After mean follow up of 36.7 months, the tumor volume was increased in only 4 patients (3.2%). The overall actuarial progression‐free survival rate was 99% at 2 years and 97% at 4 years. No difference was observed between the FRT group and the SRS group in the control of tumor growth. Based on the endocrinologic results in the patients who had secretory adenomas, the overall hormone complete remission rate was 26.2% at 2 years and 76.3% at 4 years. The median time to complete remission was 26 months in the SRS group and 63 months in the FRT group (P = .0068). Hypopituitarism developed as a delayed complication in 11.5% of patients at a median of 84 months. CONCLUSIONS. Both FRT and SRS were efficient treatment modalities for the control of tumor growth in patients with pituitary adenomas. The current results indicated that single‐dose radiosurgery more promptly produces an effect on the hypersecretion of pituitary hormones and may be recommended over FRT for suitable patients. Cancer 2007. © 2007 American Cancer Society.Keywords
This publication has 35 references indexed in Scilit:
- Linear accelerator radiosurgery for pituitary macroadenomasCancer, 2006
- Is fractionated stereotactic radiotherapy effective in pituitary adenomas?Nature Clinical Practice Oncology, 2005
- Stereotactic radiosurgery for pituitary adenomas: an intermediate review of its safety, efficacy, and role in the neurosurgical treatment armamentariumJournal of Neurosurgery, 2005
- Radiosurgery for pituitary adenomasClinical Endocrinology, 2004
- Repeated gamma knife surgery for multiple brain metastases from renal cell carcinomaJournal of Neurosurgery, 2002
- Results of stereotactic radiosurgery in patients with hormone-producing pituitary adenomas: factors associated with endocrine normalizationJournal of Neurosurgery, 2002
- Octreotide May Act as A Radioprotective Agent in AcromegalyJournal of Clinical Endocrinology & Metabolism, 2000
- Recent Results of Secondary Transnasal Surgery for Residual or Recurring AcromegalyNeurosurgery, 1998
- Radiation therapy for pituitary adenoma: Treatment outcome and prognostic factorsInternational Journal of Radiation Oncology*Biology*Physics, 1994
- Repeat transsphenoidal surgery for Cushing's diseaseJournal of Neurosurgery, 1989