| Gamma knife radiosurgery for patients with prolactin-secreting pituitary adenomas. | |
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MedLine Citation:
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PMID: 21300006 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the efficacy of stereotactic radiosurgery (SRS) for patients with prolactin (PRL)-secreting pituitary adenomas that were refractory to medical management. METHODS: Retrospective review of 22 patients treated with SRS from 1994 until 2006. All patients were either intolerant or their tumors were unresponsive to dopamine agonist therapy. Nine patients (41%) had undergone prior transsphenoidal surgery. The median serum PRL concentration before SRS was 88.4 ng/mL (range, 25-943). The median treatment volume was 2.2 cm(3) (range, 0.4-29.0); the median margin radiation dose was 25 Gy (range, 16-30). The median endocrinologic follow-up was 60 months (range, 16-129). RESULTS: Tumor control after SRS was 100%. Serum PRL concentration was significantly lower (median, 28.4 ng/mL) (P = 0.006) at last follow-up, but the 4-year actuarial rate of biochemical remission off medications was only 17%. No tested variable was associated with biochemical remission off medications. Overall, four patients (18%) had biochemical remission off medications and clinical improvement, three patients (14%) had normal serum PRL concentrations and clinical improvement on dopamine agonist therapy, seven patients (32%) had improved symptoms off medications but continued to have elevated serum PRL levels, and eight patients (36%) continued to be symptomatic with elevated PRL levels either on (n = 3) or off (n = 5) dopamine agonist therapy. The incidence of new anterior pituitary deficits was 42% at 4 years. CONCLUSIONS: SRS was effective in controlling tumor growth for patients with PRL-secreting pituitary adenomas, and the majority of patients were clinically improved. |
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Authors:
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Shota Tanaka; Michael J Link; Paul D Brown; Scott L Stafford; William F Young; Bruce E Pollock |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: World neurosurgery Volume: 74 ISSN: 1878-8750 ISO Abbreviation: World Neurosurg Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2011-02-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101528275 Medline TA: World Neurosurg Country: United States |
Other Details:
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Languages: eng Pagination: 147-52 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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