Fractionated stereotactically guided radiotherapy and radiosurgery in the treatment of functional and nonfunctional adenomas of the pituitary gland

Int J Radiat Oncol Biol Phys. 2001 Aug 1;50(5):1279-86. doi: 10.1016/s0360-3016(01)01535-8.

Abstract

Purpose: We evaluated survival rates and side effects after fractionated stereotactically guided radiotherapy (SCRT) and radiosurgery in patients with pituitary adenoma.

Methods and materials: Between 1989 and 1998, 68 patients were treated with FSRT (n = 63) or radiosurgery (n = 5) for pituitary adenomas. Twenty-six had functional and 42 had nonfunctional adenomas. Follow-up included CT/MRI, endocrinologic, and ophthalmologic examinations. Mean follow-up was 38.7 months. Seven patients received radiotherapy as primary treatment and 39 patients received it postoperatively for residual disease. Twenty-two patients were treated for recurrent disease after surgery. Mean total dose was 52.2 Gy for SCRT, and 15 Gy for radiosurgery.

Results: Overall local tumor control was 93% (60/65 patients). Forty-three patients had stable disease based on CT/MRI, while 15 had a reduction of tumor volume. After FSRT, 26% with a functional adenoma had a complete remission and 19% had a reduction of hormonal overproduction after 34 months' mean. Two patients with STH-secreting adenomas had an endocrinologic recurrence, one with an ACTH-secreting adenoma radiologic recurrence, within 54 months. Reduction of visual acuity was seen in 4 patients and partial hypopituitarism in 3 patients. None of the patients developed brain radionecrosis or radiation-induced gliomas.

Conclusion: Stereotactically guided radiotherapy is effective and safe in the treatment of pituitary adenomas to improve local control and reduce hormonal overproduction.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adenoma / mortality
  • Adenoma / radiotherapy*
  • Adenoma / surgery*
  • Adolescent
  • Adult
  • Aged
  • Child
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Life Tables
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / radiotherapy
  • Pituitary Irradiation* / adverse effects
  • Pituitary Neoplasms / mortality
  • Pituitary Neoplasms / radiotherapy*
  • Pituitary Neoplasms / surgery*
  • Radiosurgery* / adverse effects
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Adjuvant
  • Remission Induction
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome