Fractionated stereotactic conformal radiotherapy for secreting and nonsecreting pituitary adenomas

Abstract

SCRT as a high-precision technique of localized irradiation achieves tumour and hormone control of pituitary adenomas comparable with previously published data on the efficacy of conventional radiotherapy. Despite the potential advantage of reducing the volume of normal brain irradiated, the theoretical benefit over conventional radiotherapy in terms of the reduction in long-term morbidity has not yet been demonstrated and requires longer follow-up. Potential effect on long-term cognitive function has not been tested.

Fractionated stereotactic radiotherapy in patients with acromegaly: an interim single-centre audit

“…Also, the criteria for biochemical success were not clear in some papers (13,15). The present study thus brings new data on efficacy of both hormonal and radiological controls of acromegaly after FSRT, and also has the highest number of patients in which FSRT on acromegaly was evaluated (nZ34) (13)(14)(15)(16)(17).…”

“…efficacy on a mixture of pituitary tumours, not confined to GH-producing adenomas (13)(14)(15), and the patients with acromegaly were difficult to identify from the other groups. Also, the criteria for biochemical success were not clear in some papers (13,15).…”

“…(Table 5). However, the present study has added knowledge about biochemical discordance between IGF1 and GH/nadir GH, which was not evaluated in most existing papers regarding acromegalic patients treated with FSRT, probably because the acromegalic patients were a subgroup of patients with various pituitary tumours (13)(14)(15).…”

Radiation therapy in the treatment of pituitary tumors

“…13,26,41,42,52 Similarly, fractionated SRT produces a growth control rate of 86-100% and a 5-year progressionfree survival rate close to 90%. 6,7,32,34,35,39 Thus, the literature does not suggest any significant difference in outcomes between the use of SRS and fractionated SRT.…”

“…These techniques use either gamma radiation (with the Gamma Knife), a modified linear accelerator, or proton beams. Minniti et al 34 reviewed 13 studies of SRS for NSA, and reported a tumor growth control rate of 87-100% with a follow-up of 6-60 months. There have only been a few studies showing the progression-free survival after radiosurgery for NSA.…”