Is it possible to avoid hypopituitarism after irradiation of pituitary adenomas by the Leksell gamma knife?
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
21071488
DOI
10.1530/eje-10-0733
PII: EJE-10-0733
Knihovny.cz E-resources
- MeSH
- Adenoma blood surgery MeSH
- Analysis of Variance MeSH
- Radiotherapy Dosage MeSH
- Adult MeSH
- Estradiol blood MeSH
- Follicle Stimulating Hormone blood MeSH
- Hydrocortisone blood MeSH
- Pituitary Gland surgery MeSH
- Hypopituitarism blood etiology MeSH
- Insulin-Like Growth Factor I MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Pituitary Neoplasms blood surgery MeSH
- Prolactin blood MeSH
- Proportional Hazards Models MeSH
- Radiosurgery adverse effects instrumentation MeSH
- Aged MeSH
- Testosterone blood MeSH
- Thyrotropin blood MeSH
- Thyroxine blood MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Estradiol MeSH
- Follicle Stimulating Hormone MeSH
- Hydrocortisone MeSH
- Insulin-Like Growth Factor I MeSH
- Prolactin MeSH
- Testosterone MeSH
- Thyrotropin MeSH
- Thyroxine MeSH
OBJECTIVE: Radiation therapy is one of the treatment options for pituitary adenomas. The most common side effect associated with Leksell gamma knife (LGK) irradiation is the development of hypopituitarism. The aim of this study was to verify that hypopituitarism does not develop if the maximum mean dose to pituitary is kept under 15 Gy and to evaluate the influence of maximum distal infundibulum dose on the development of hypopituitarism. DESIGN AND METHODS: We followed the incidence of hypopituitarism in 85 patients irradiated with LGK in 1993-2003. The patients were divided in two subgroups: the first subgroup followed prospectively (45 patients), irradiated with a mean dose to pituitary <15 Gy; the second subgroup followed retrospectively 1993-2001 and prospectively 2001-2009 (40 patients), irradiated with a mean dose to pituitary >15 Gy. Serum TSH, free thyroxine, testosterone or 17β-oestradiol, IGF1, prolactin and cortisol levels were evaluated before and every 6 months after LGK irradiation. RESULTS: Hypopituitarism after LGK irradiation developed only in 1 out of 45 (2.2%) patients irradiated with a mean dose to pituitary <15 Gy, in contrast to 72.5% patients irradiated with a mean dose to pituitary >15 Gy. The radiation dose to the distal infundibulum was found as an independent factor of hypopituitarism with calculated maximum safe dose of 17 Gy. CONCLUSION: Keeping the mean radiation dose to pituitary under 15 Gy and the dose to the distal infundibulum under 17 Gy prevents the development of hypopituitarism following LGK irradiation.
References provided by Crossref.org
Role of gamma knife radiosurgery in the treatment of prolactinomas
Gamma knife radiosurgery for Cushing's disease and Nelson's syndrome
