Gamma knife radiosurgery for endocrine-inactive pituitary adenomas
Language English Country Austria Media print-electronic
Document type Evaluation Study, Journal Article
- MeSH
- Adenoma surgery MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local diagnosis surgery MeSH
- Magnetic Resonance Imaging MeSH
- Pituitary Neoplasms diagnosis surgery MeSH
- Follow-Up Studies MeSH
- Neuronavigation * MeSH
- Image Processing, Computer-Assisted MeSH
- Postoperative Complications diagnosis MeSH
- Radiosurgery * MeSH
- Reoperation MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Pituitary Function Tests MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Evaluation Study MeSH
BACKGROUND: The goal of nonsecreting pituitary adenoma radiosurgery is to halt tumour growth and to maintain normal performance of the hypophysis and the functionally important structures around the sella. The effectiveness of gamma knife radiosurgery was evaluated. METHOD: Over a period of 10 years (1993-2003), 140 patients with nonsecreting pituitary adenoma were treated by Leksell gamma knife at our Centre. Seventy-nine of them were followed up for longer than 3 years. Their age range was 24-73 years, with a median of 54 years. Eighty-five percent of them had previous open surgery. Fifteen patients had adenoma contact with the optic tract. Fourteen patients had a normally functioning hypophysis, 48 patients had complete panhypopituitarism, while the rest retained partial functions of the normal hypophysis. Adenoma volumes ranged between 0.1 and 31.3, the median being 3.45 ccm. The marginal dose ranged between 12 and -35 Gy, with a median of 20 Gy. FINDINGS: The follow-up ranged from 36 to 122 months, with a median of 60 months. No adenoma growth was detected; 89% of treated adenomas decreased in size, with a median volume reduction of 61%. There was no perimeter vision impairment after radiosurgery, while 4 out of 52 patients with abnormal perimeter vision reported improvement. There was no impairment of oculomotor nerve function. Impairment of hypophysis function was observed in 2 patients. CONCLUSIONS: Radiosurgery has a reliable antiproliferative effect on nonsecreting pituitary adenomas. It is a safe treatment with a low risk of morbidity. Short contact between a nonsecreting pituitary adenoma and the optic pathway is not an absolute contraindication for Gamma knife radiosurgery.
References provided by Crossref.org
Gamma knife radiosurgery for Cushing's disease and Nelson's syndrome
