External Beam Radiation Therapy and Stereotactic Radiosurgery for Pituitary Adenomas

Sheehan, Jason P.; Xu, Zhiyuan; Lobo, M.

doi:10.1016/j.nec.2012.06.011

Cited by 28 publications

(31 citation statements)

References 84 publications

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“…RT is used where surgery is contraindicated and for recurrence or progression of non-secreting adenomas or hormonally uncontrolled tumours after maximal surgical and medical therapy [29,30]. Over the past decade, stereotactic radiosurgery (SRS), delivering a large single dose of highly collimated radiation and fractionated stereotactic RT (FRST) delivered over 5-6 weeks, with higher precision and less tissue damage but requiring a longer period to achieve biochemical normalisation, has emerged [29,30].…”

Section: Management Of Ppasmentioning

confidence: 99%

Paediatric Pituitary Adenomas: A Decade of Change

et al. 2014

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Pituitary adenomas, although rare in the paediatric age range and mostly benign, represent very challenging disorders for diagnosis and management. The recent identification of genetic alterations in young individuals with pituitary adenomas has broadened the scope of molecular investigations and contributed to the understanding of mechanisms of tumorigenesis. Recent identification of causative mutations of genes such as GNAS, PRKAR1A, MEN1 and AIP has introduced the concept of molecular screening of young apparently healthy family members. Population-based studies have reported a significantly higher number of affected subjects and genetic variations than expected. Radiological techniques have advanced, yet many microadenomas remain undetectable on scanning. However, experience with transsphenoidal and endoscopic pituitary surgery has led to higher rates of cure. Prolactinomas, corticotroph and somatotroph adenomas remain the most prevalent, with each diagnosis presenting its own challenges. As paediatric pituitary adenomas occur very infrequently within the paediatric age range, paediatric endocrine units cannot provide expert management in isolation. Consequently, close co-operation with adult endocrinology colleagues with experience of pituitary disease is strongly recommended.

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Section: Management Of Ppasmentioning

confidence: 99%

Paediatric Pituitary Adenomas: A Decade of Change

et al. 2014

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“…Its rate of remission and side-effect profile are superior to those for fractionated radiation therapy. 9 Tumor control after GKS is greater than 90% in most functioning adenoma series. 2,5,[7][8][9] However, endocrine remission rates vary from 40% to 80%.…”

Section: Disclosurementioning

confidence: 99%

“…9 Tumor control after GKS is greater than 90% in most functioning adenoma series. 2,5,[7][8][9] However, endocrine remission rates vary from 40% to 80%. 2,5,[7][8][9] This disparity between tumor control and endocrine remission underscores an opportunity for significant improvement in outcomes.…”

Section: Disclosurementioning

confidence: 99%

“…2,5,[7][8][9] However, endocrine remission rates vary from 40% to 80%. 2,5,[7][8][9] This disparity between tumor control and endocrine remission underscores an opportunity for significant improvement in outcomes. Avenues for such improvement will probably occur through pharmacological alterations in the tumor biology, allowing for enhanced target delineation on neuroimaging studies and a more favorable response to ionizing radiation.…”

Section: Disclosurementioning

confidence: 99%

“…4 This endocrine remission rate is not markedly different from those in published studies using moderate doses. 2,5,[7][8][9] Earlier work at the Karolinska Institute, where high doses were used in patients with acromegaly and Cushing's disease, showed no substantial enhancement in endocrine remission. 11,12 In vitro work by the same team identified a high degree of radioresistance by certain adenoma cells that could withstand doses of up to 150 Gy while still maintaining intact cellular ultrastructure and hormone granules.…”

Section: Disclosurementioning

confidence: 99%

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