BACKGROUND: Radiotherapy for pituitary adenomas is an effective treatment but remains controversial due to toxicity concerns. MATERIALS AND METHODS: A retrospective audit of patients referred for radiotherapy during 1974-2003 was conducted, the case records were examined and data linkage to cancer registry and hospital discharge records was performed to assess the overall survival (OS), progression-free survival (PFS) and late effects (hormone deficiency, reduced vision, second cancer and stroke). RESULTS: Three hundred and eighty-five patients had radiotherapy (median 45 Gy). The OS was 74% and 49%, PFS was 97% and 96%, at 10 and 20 years, respectively. No specific factors influenced local control. Additional hormone deficiencies occurred in 19% (ACTH) and 26% (TSH). Actuarial rate optic neuropathy at 10 years was 0.8%. Seventy-eight patients had a stroke, a RR for a matched Scottish population of 1.45 (CI 1.05-1.18, p=0.03) men and 2.22 (1.56-3.08, p<0.01) women. Four intra-cranial tumours were identified; 20-year actuarial risk 1.9% (CI 0-2.6%), a RR of 5.65 (0.53-20.77, p=0.10) men and 9.94 (0.94-36.56, p=0.04) women. CONCLUSIONS: This treatment is effective with good local control rates at 20 years. A significant proportion developed hypo-pituitarism. The risk of optic neuropathy was low but risk of stroke increased, particularly in women who had slight increased risk of intra-cranial tumours.
BACKGROUND: Radiotherapy for pituitary adenomas is an effective treatment but remains controversial due to toxicity concerns. MATERIALS AND METHODS: A retrospective audit of patients referred for radiotherapy during 1974-2003 was conducted, the case records were examined and data linkage to cancer registry and hospital discharge records was performed to assess the overall survival (OS), progression-free survival (PFS) and late effects (hormone deficiency, reduced vision, second cancer and stroke). RESULTS: Three hundred and eighty-five patients had radiotherapy (median 45 Gy). The OS was 74% and 49%, PFS was 97% and 96%, at 10 and 20 years, respectively. No specific factors influenced local control. Additional hormone deficiencies occurred in 19% (ACTH) and 26% (TSH). Actuarial rate optic neuropathy at 10 years was 0.8%. Seventy-eight patients had a stroke, a RR for a matched Scottish population of 1.45 (CI 1.05-1.18, p=0.03) men and 2.22 (1.56-3.08, p<0.01) women. Four intra-cranial tumours were identified; 20-year actuarial risk 1.9% (CI 0-2.6%), a RR of 5.65 (0.53-20.77, p=0.10) men and 9.94 (0.94-36.56, p=0.04) women. CONCLUSIONS: This treatment is effective with good local control rates at 20 years. A significant proportion developed hypo-pituitarism. The risk of optic neuropathy was low but risk of stroke increased, particularly in women who had slight increased risk of intra-cranial tumours.
Authors: P D Delgado-López; J Pi-Barrio; M T Dueñas-Polo; M Pascual-Llorente; M C Gordón-Bolaños Journal: Clin Transl Oncol Date: 2018-04-05 Impact factor: 3.405
Authors: Reem D Almutairi; Ivo S Muskens; David J Cote; Mark D Dijkman; Vasileios K Kavouridis; Erin Crocker; Kholoud Ghazawi; Marike L D Broekman; Timothy R Smith; Rania A Mekary; Hasan A Zaidi Journal: Acta Neurochir (Wien) Date: 2018-01-06 Impact factor: 2.216
Authors: Lawrence J Sheplan Olsen; Lizbeth Robles Irizarry; Samuel T Chao; Robert J Weil; Amir H Hamrahian; Betul Hatipoglu; John H Suh Journal: Pituitary Date: 2012-06 Impact factor: 4.107
Authors: C Kopp; M Theodorou; N Poullos; S T Astner; H Geinitz; G K Stalla; B Meyer; M Molls; C Nieder; A-L Grosu Journal: Strahlenther Onkol Date: 2013-09-08 Impact factor: 3.621
Authors: Valerie Panet-Raymond; Kushraw Sabit; George Shenouda; Denis Sirhan; Anthony Zeitouni; Luis Souhami Journal: J Neurol Surg B Skull Base Date: 2018-10-10