Article
Stereotactic LINAC-radiosurgery for non-secreting pituitary adenomas: long-term results
Search Medline for
Authors
Published: | May 20, 2009 |
---|
Outline
Text
Objective: During the last years stereotactic radiosurgery has become an increasingly utilised therapeutic option for microsurgically inaccessible remnants or recurrence of pituitary adenomas. We present long-term results of patients treated with stereotactic linear accelerator based radiosurgery (LINAC-RS) for non-secreting pituitary adenomas (NSAs).
Methods: Between 1992 and August 2008 65 NSAs were treated with LINAC-RS. Patient treatment and follow-up were conducted according to a prospective protocol. The indication for LINAC-RS was progressive recurrent tumour in 35 cases (58%) and tumour remnant after (repeated) surgery in 23 (38%). 2 patients (3%) declined surgery and were treated with primary radiosurgery. The clinical and endocrinological courses as well as consecutive MRI-scans of 60 patients with a minimum follow-up of 12 months were evaluated retrospectively.
Results: The mean tumour volume was 5.2cm³ (standard deviation 4.2cm³, range 0.3–17.3cm³), and the mean therapeutic dose 13Gy (standard deviation 1.7Gy). A mean maximum dose of 28.8Gy (standard deviation 10.2Gy) was applied. Mean follow-up of the 60 patients was 91 months (range 15–189mth). One patient died of unknown reason 3 years after treatment. Two patients (3.3%) developed neurological deficits. In 38 of 43 patients (88%) LINAC-RS caused no adverse effects concerning pituitary function. 98% of the cases showed local tumour control, and in 41% the tumours exhibited partial remission following LINAC-RS.
Conclusions: LINAC-RS is a minimally invasive, safe and effective treatment for recurrent NSA or microsurgically inaccessible tumour remnants. LINAC-RS yielded a high rate of local tumour control with a small number of radiation-induced side effects.