PMID: 9169809Mar 15, 1997Paper

Symptom resolution, tumor control, and side effects following postoperative radiotherapy for pituitary macroadenomas

International Journal of Radiation Oncology, Biology, Physics
S Rush, P R Cooper

Abstract

This study reports the outcome of 70 patients who were treated by a consistent treatment plan of surgery and postoperative radiotherapy (RT) for pituitary macroadenomas in the modern era [computed tomographic scan or magnetic resonance imaging (MRI), dopamine agonist therapy (DA) added as indicated, and immunohistochemical staining]. Sixty-two patients underwent transsphenoidal surgery (vs. transcranial surgery) and 61 received 45-Gy/25 fractions postoperatively (vs. other dose fractionation schemes). Twenty-four patients received DA for prolactin-secreting tumors. With a median follow-up of 8 years (range 2-15), 68 patients have experienced continuous control of their tumors. Most symptoms related to mass effect abated, while physiologic symptoms such as amenorrhea from markedly elevated prolactin levels tended to persist. Treatment-induced hypopituitarism occurred in 42% of the patients at risk. No patients in this series have died as a result of their pituitary tumor. No gross neuropsychologic dysfunction after treatment has been noted. While it is possible at this time with serial MRI to withhold postoperative RT and observe some patients who have had a "gross total" resection of a macroadenoma, the therapeutic ratio for su...Continue Reading

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Citations

Feb 14, 2008·Pituitary·Ken H Darzy, Stephen M Shalet
Sep 13, 2008·Reviews in Endocrine & Metabolic Disorders·G MinnitiM Brada
Feb 15, 2005·International Journal of Radiation Oncology, Biology, Physics·Sun Ha PaekDavid W Andrews
Apr 15, 2003·Neurosurgery Clinics of North America·Zbigniew PetrovichMichael L J Apuzzo
Jan 24, 2009·Nature Clinical Practice. Endocrinology & Metabolism·Ken H Darzy
Nov 18, 2008·Thyroid : Official Journal of the American Thyroid Association·Marco LosaRoberto Lanzi
Jul 26, 2012·Systematic Reviews·Amy T WangMohammad Hassan Murad
Jan 27, 2005·Neurosurgical Focus·Thomas C Witt
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Mar 1, 2011·Expert Review of Endocrinology & Metabolism·Betül A Hatipoglu, Laurence Kennedy
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