Stereotactic radiotherapy for the treatment of pituitary adenomas

Michael T. Selch, A. Gorgulho, S. P. Lee, C. Mattozo, T. D. Solberg, N. Agazaryan, A. A F DeSalles

Research output: Contribution to journalArticle

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Abstract

Purpose: The aim of this study was to retrospectively review local control and morbidity following stereotactic radiotherapy (SRT) for pituitary adenoma. Methods: Between 1997 and 2004, 39 patients with pituitary adenomas received SRT. Median age was 56 years (range: 13 to 90 years). Thirty-three patients underwent incomplete transsphenoidal surgery prior to SRT and six had unresectable tumors. The largest tumor dimension varied from 1.7 to 6 cm (median: 3 cm). Tumor volume varied from 1.2 to 56 mL (median 10.5 mL). Thirty-five tumors were ≤ 1 mm from the optic chiasm/nerve. Thirty-three tumors were non-functional. SRT was delivered by a dedicated linear accelerator (Novalis, Heimstetten, Germany). Beam collimation was achieved by a fixed circular collimator (five patients) or a micro-multileaf collimator (34 patients). Total dose varied from 4500 to 5040 cGy (median: 4860 cGy) and was prescribed at the 90% isodose line. Results: After a median follow-up of 32 months (range: 12 to 94 months), the local control rate was 100%. Tumor size was stable in 26 patients and decreased in 13 patients. Hormone normalization did not occur following SRT. New endocrine deficiency occurred in six patients. No patient developed cranial nerve injury or second malignancy following treatment. Conclusions: SRT achieves a high rate of local control and a low rate of treatment-induced morbidity. SRT is applicable to pituitary adenomas in close proximity to the optic apparatus and tumors in excess of three centimeters in the greatest dimension. Further follow-up is necessary to establish the long-term outcome following SRT for pituitary adenomas.

Original languageEnglish (US)
Pages (from-to)150-155
Number of pages6
JournalMinimally Invasive Neurosurgery
Volume49
Issue number3
DOIs
StatePublished - Jun 2006

Fingerprint

Pituitary Neoplasms
Radiotherapy
Neoplasms
Therapeutics
Cranial Nerve Injuries
Morbidity
Optic Chiasm
Particle Accelerators
Second Primary Neoplasms
Optic Nerve
Tumor Burden
Germany
Hormones

Keywords

  • Pituitary adenoma
  • Stereotactic radiotherapy

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Selch, M. T., Gorgulho, A., Lee, S. P., Mattozo, C., Solberg, T. D., Agazaryan, N., & DeSalles, A. A. F. (2006). Stereotactic radiotherapy for the treatment of pituitary adenomas. Minimally Invasive Neurosurgery, 49(3), 150-155. https://doi.org/10.1055/s-2006-944240

Stereotactic radiotherapy for the treatment of pituitary adenomas. / Selch, Michael T.; Gorgulho, A.; Lee, S. P.; Mattozo, C.; Solberg, T. D.; Agazaryan, N.; DeSalles, A. A F.

In: Minimally Invasive Neurosurgery, Vol. 49, No. 3, 06.2006, p. 150-155.

Research output: Contribution to journalArticle

Selch, MT, Gorgulho, A, Lee, SP, Mattozo, C, Solberg, TD, Agazaryan, N & DeSalles, AAF 2006, 'Stereotactic radiotherapy for the treatment of pituitary adenomas', Minimally Invasive Neurosurgery, vol. 49, no. 3, pp. 150-155. https://doi.org/10.1055/s-2006-944240
Selch MT, Gorgulho A, Lee SP, Mattozo C, Solberg TD, Agazaryan N et al. Stereotactic radiotherapy for the treatment of pituitary adenomas. Minimally Invasive Neurosurgery. 2006 Jun;49(3):150-155. https://doi.org/10.1055/s-2006-944240
Selch, Michael T. ; Gorgulho, A. ; Lee, S. P. ; Mattozo, C. ; Solberg, T. D. ; Agazaryan, N. ; DeSalles, A. A F. / Stereotactic radiotherapy for the treatment of pituitary adenomas. In: Minimally Invasive Neurosurgery. 2006 ; Vol. 49, No. 3. pp. 150-155.
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AU - DeSalles, A. A F

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AB - Purpose: The aim of this study was to retrospectively review local control and morbidity following stereotactic radiotherapy (SRT) for pituitary adenoma. Methods: Between 1997 and 2004, 39 patients with pituitary adenomas received SRT. Median age was 56 years (range: 13 to 90 years). Thirty-three patients underwent incomplete transsphenoidal surgery prior to SRT and six had unresectable tumors. The largest tumor dimension varied from 1.7 to 6 cm (median: 3 cm). Tumor volume varied from 1.2 to 56 mL (median 10.5 mL). Thirty-five tumors were ≤ 1 mm from the optic chiasm/nerve. Thirty-three tumors were non-functional. SRT was delivered by a dedicated linear accelerator (Novalis, Heimstetten, Germany). Beam collimation was achieved by a fixed circular collimator (five patients) or a micro-multileaf collimator (34 patients). Total dose varied from 4500 to 5040 cGy (median: 4860 cGy) and was prescribed at the 90% isodose line. Results: After a median follow-up of 32 months (range: 12 to 94 months), the local control rate was 100%. Tumor size was stable in 26 patients and decreased in 13 patients. Hormone normalization did not occur following SRT. New endocrine deficiency occurred in six patients. No patient developed cranial nerve injury or second malignancy following treatment. Conclusions: SRT achieves a high rate of local control and a low rate of treatment-induced morbidity. SRT is applicable to pituitary adenomas in close proximity to the optic apparatus and tumors in excess of three centimeters in the greatest dimension. Further follow-up is necessary to establish the long-term outcome following SRT for pituitary adenomas.

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