Clinical results of 24 pituitary macroadenomas with linac-based stereotactic radiosurgery

Yoon, Seung Bae; Suh, Tae-Suk; Jang, Hong-Seok; Chung, Sung-Chong; Kim, Yeon-Shil; Ryu, Mi-Ryeong; Choi, Kyu-Ho; Son, Ho-Yong; Kim, Moon-Chan; Shinn, Kyung Sub

doi:10.1016/s0360-3016(98)00124-2

Cited by 97 publications

(49 citation statements)

References 9 publications

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“…Thirteen (37%) of these patients achieved normal cortisol levels, while 4 (11%) achieved a cure and required placement. This is comparable to other rates reported in the literature which state normalization of cortisol levels ranging from 27 to 66% [3,5,6,9,[18][19][20][21][22][23][24][25][26].…”

Section: Discussionsupporting

confidence: 88%

The Efficacy of Linear Accelerator Radiosurgery in the Management of Patients with Cushing’s Disease

Devin

Allen

Cmelak

et al. 2004

Stereotact Funct Neurosurg

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We identified 35 patients who had undergone stereotactic radiosurgery (SRS) for their biochemically proven Cushing’s disease in order to assess the efficacy of SRS with regard to control of hypercortisolism, improvement of clinical features and prevention of tumor progression, and subsequent incidence of hypopituitarism. Seventeen (49%) patients achieved control of their cortisol levels following SRS; the mean time to normalization was 7.5 months (range: 1–33). Four (19%) patients experienced recurrent hypercortisolism at a mean time of 35.5 months following therapy (range: 17–64). Control of tumor progression was achieved in 91% patients. Fourteen (40%) patients demonstrated a new pituitary deficiency following SRS. Our results suggest that cortisol levels are normalized more efficiently and with a lower recurrence rate with SRS than with conventional fractionated external beam radiotherapy (EBT). We have confirmed the near 100% tumor control rate reported with SRS. The percentage of patients developing pituitary insufficiency following SRS is less than that of patients having undergone EBT; however, deficits occurred up to 10 years posttreatment. We advocate the use of SRS as the primary therapeutic modality in those patients who are poor surgical candidates, or as the adjunct treatment to microsurgery in eliminating residual tumor cells or disease that is not easily amenable to resection.

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Section: Discussionsupporting

confidence: 88%

The Efficacy of Linear Accelerator Radiosurgery in the Management of Patients with Cushing’s Disease

Devin

Allen

Cmelak

et al. 2004

Stereotact Funct Neurosurg

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“…The search identified 584 candidate references, of which 28 were studies deemed to be eligible (16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,38,39,40,41,42,43,44,45,46,47,48). We excluded six studies (42,44,45,46,47,48) because the stereotactic radiosurgery was carried with a CyberKnife or linear accelerator. One study had few patients (nZ3) who underwent GKS (43).…”

Section: Search Resultsmentioning

confidence: 99%

Gamma knife surgery for patients with volumetric classification of nonfunctioning pituitary adenomas: a systematic review and meta-analysis

Chen

Zhang

et al. 2013

European Journal of Endocrinology

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Objective: The aim of this study was to scrutinize the literature to determine the efficacy and safety of gamma knife surgery (GKS) for the treatment of nonfunctioning pituitary adenomas (NFPAs) with volumetric classification. Methods: Electronic databases including MedLine, PubMed, and Cochrane Central were searched. The literature related to patients with NFPAs treated with GKS was collected. Eligible studies reported on the rate of tumor control (RTC), the rate of radiosurgery-induced optic neuropathy injury (RRIONI), the rate of radiosurgery-induced endocrinological deficits (RRIED), and other parameters. Results: A total of 17 studies met the criteria. Based on the tumor volume, NFPAs were divided into three groups: the RTC of group I (93 patients) with tumor volumes !2 ml was 99% (95% CI 96-100%), the RRIONI was 1% (95% CI 0-4%), and the RRIED was 1% (95% CI 0-4%). The RTC of group II (301 patients) with volumes from 2 to 4 ml was 96% (95% CI 92-99%), the RRIONI was 0 (95% CI 0-2%), and RRIED was 7% (95% CI 2-14%). The RTC of group III (531 patients) with volumes larger than 4 ml was 91% (95% CI 89-94%), the RRIONI was 2% (95% CI 0-5%), and the RRIED was 22% (95% CI 14-31%). There were significant differences in the RTC and in the RRIED among the three groups (P!0.001), indicating that there were higher RRIED and lower RTC with the increase of tumor volume. Conclusions: NFPAs, according to tumor volume classification, need stratification for GKS treatment. GKS is the optimal choice for the treatment of group II NFPAs. Patients with residual tumor volumes of !4 ml will benefit most from GKS treatment.

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“…Witt et al 51 reviewed 20 different radiosurgery studies published between 1997 and 2002 and found that tumor control ranged from 68 to 100% (but most studies showed Ͼ 90% growth control). He also found endocrine improvement in 0 16,29,53,54 to 67%, 35 depending on the study. The endocrine cure in the different studies ranged from 0 16,36 to 96%.…”

Section: Acromegalymentioning

confidence: 90%

Radiation therapy in the treatment of pituitary tumors

Ghostine

Johnson³

2008

FOC

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✓ The treatment of pituitary tumors has progressed into a multidisciplinary approach that involves neurosurgeons, radiation oncologists, and endocrinologists. This has allowed improved outcomes in treatment of pituitary tumors due to a combination of surgical, medical, and radiation therapies. In this study, the authors review the role of radiation therapy in the treatment of pituitary adenomas.

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Clinical results of 24 pituitary macroadenomas with linac-based stereotactic radiosurgery

Cited by 97 publications

References 9 publications

The Efficacy of Linear Accelerator Radiosurgery in the Management of Patients with Cushing’s Disease

The Efficacy of Linear Accelerator Radiosurgery in the Management of Patients with Cushing’s Disease

Gamma knife surgery for patients with volumetric classification of nonfunctioning pituitary adenomas: a systematic review and meta-analysis

Radiation therapy in the treatment of pituitary tumors

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