gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Radiosurgery (RS) and stereotactic radiotherapy (SRT) for residual or recurrent pituitary adenomas

Radiochirurgie (RS) und stereotaktische Radiotherapie (SRT) bei Rest- oder Rezidiv-Hypophysenadenomen

Meeting Abstract

Suche in Medline nach

  • corresponding author K. Hamm - Abteilung für stereotaktische Neurochirurgie und Radiochirurgie, Helios Klinikum Erfurt
  • G. Kleinert - Abteilung für stereotaktische Neurochirurgie und Radiochirurgie, Helios Klinikum Erfurt
  • G. Surber - Abteilung für stereotaktische Neurochirurgie und Radiochirurgie, Helios Klinikum Erfurt

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-07.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0024.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Hamm et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

RS as a single high dose and SRT as a fractionated dose delivery, both are highly precise stereotactic radiation techniques which ensure reduction of the normal tissue volume being irradiated compared to conventional external radiation therapy. Therefore RS or SRT should be used if radiotherapy was chosen to treat growing residual or recurrent pituitary adenomas.

Methods

Between May 2000 and May 2004, 51 patients with residual or recurrent pituitary adenomas were treated, among them 16 (14 secretory) small adenomas with RS (distance from visual pathways 6 mm) and 35 (5 secretory) adenomas in close proximity to or even compressing the optic chiasm with SRT. The results until now with a mean follow-up of 36 months (10-54 mo.) were analysed. In case of the RS-treated patients the tumour volumes ranged from 0.1 to 2.2 ccm and the delivered prescription isodose (80%) reached 12-16 Gy. The 35 patients treated with SRT (their irregular tumour volume ranged from 2.2 to 62.7 ccm) received a total dose of 50–54 Gy in standard fractions of 1.8 or 2 Gy per fraction (isocenter dose values).

Results

Until now, no tumour growth occurred. A tumour regression (more than 20%) was proved in 5/16 RS-treated and in 21/35 SRT-treated cases. 2 patients developed a mild increase in visual disturbances on the most affected eye, in 6 cases visual function improved. No patient got a new neurological deficit. Decreased or normal serum hormone values were seen in 5/14 cases with secretory adenomas after RS, in 2/5 cases after SRT.

Conclusions

For residual or recurrent pituitary adenomas, RS and SRT are low risk and effective treatment options for tumour control, but less effective for hormonal normalization. Due to the slow radiobiological effects, RS and SRT are more recommended for nonsecreting adenomas. Particularly in cases with cavernous sinus-invading tumours, RS or SRT can be the treatment of choice.