Stereotactic radiosurgery as an alternative to fractionated radiotherapy for patients with recurrent or residual nonfunctioning pituitary adenomas. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: To evaluate tumor control rates and complications after stereotactic radiosurgery for patients with nonfunctioning pituitary adenomas. METHODS: Between 1992 and 2000, 33 patients underwent radiosurgery for treatment of nonfunctioning pituitary adenomas. Thirty-two patients (97%) had undergone one or more previous tumor resections. Twenty-two patients (67%) had enlarging tumors before radiosurgery. The median tumor margin dose was 16 Gy (range, 12-20 Gy). The median follow-up period after radiosurgery was 43 months (range, 16-106 mo). RESULTS: Tumor size decreased for 16 patients, remained unchanged for 16 patients, and increased for 1 patient. The actuarial tumor growth control rates at 2 and 5 years after radiosurgery were 97%. No patient demonstrated any decline in visual function. Five of 18 patients (28%) with anterior pituitary function before radiosurgery developed new deficits, at a median of 24 months after radiosurgery. The actuarial risks of developing new anterior pituitary deficits were 18 and 41% at 2 and 5 years, respectively. No patient developed diabetes insipidus. CONCLUSION: Stereotactic radiosurgery safely provides a high tumor control rate for patients with recurrent or residual nonfunctioning pituitary adenomas. However, despite encouraging early results, more long-term information is needed to determine whether radiosurgery is associated with lower risks of new endocrine deficits and radiation-induced neoplasms, compared with fractionated radiotherapy.

publication date

  • November 1, 2003

Research

keywords

  • Adenoma
  • Neoplasm Recurrence, Local
  • Neoplasm, Residual
  • Pituitary Neoplasms
  • Radiosurgery

Identity

Scopus Document Identifier

  • 0242666269

Digital Object Identifier (DOI)

  • 10.1227/01.neu.0000088661.81189.66

PubMed ID

  • 14580275

Additional Document Info

volume

  • 53

issue

  • 5