| Gamma knife radiosurgery: a safe and effective salvage treatment for pituitary tumours not controlled despite conventional radiotherapy. | |
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MedLine Citation:
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PMID: 19773368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We report the use of 'gamma knife' (GK) radiosurgery in 25 patients with pituitary adenomas not cured despite conventional therapy, including external beam radiotherapy. PATIENTS AND METHODS: All patients had previously received conventional radiotherapy for a mean of 11.8 years prior to receiving GK; 23 out of 25 had also undergone pituitary surgery on at least one occasion. Seventeen had hyperfunctioning adenomas that still required medical therapy without an adequate biochemical control--ten somatotroph adenomas, six corticotroph adenomas and one prolactinoma, while eight patients had non-functioning pituitary adenomas (NFPAs). RESULTS: Following GK, mean GH fell by 49% at 1 year in patients with somatotroph tumours. Serum IGF1 fell by 32% at 1 year and by 38% at 2 years. To date, 80% of the patients with acromegaly have achieved normalisation of IGF1, and 30% have also achieved a mean GH level of <1.8 ng/ml correlating with normalised mortality. A total of 75% NFPAs showed disease stabilisation or shrinkage post GK. The patient with a prolactinoma showed a dramatic response: 75% reduction in prolactin at 2 years, with a marked shrinkage on magnetic resonance imaging. The results in corticotroph adenomas were variable. Prior to GK, 72% of the patients were panhypopituitary, and 42% of the remainder have developed new anterior pituitary hormone deficiencies to date. No other adverse events have been detected at a mean follow-up of 36.4 months. CONCLUSIONS: These data indicate that GK is a safe and effective adjunctive treatment for patients with NFPAs and acromegaly not satisfactorily controlled with surgery and radiotherapy. |
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Authors:
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F M Swords; J P Monson; G M Besser; S L Chew; W M Drake; A B Grossman; P N Plowman |
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Publication Detail:
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Type: Journal Article Date: 2009-09-22 |
Journal Detail:
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Title: European journal of endocrinology / European Federation of Endocrine Societies Volume: 161 ISSN: 1479-683X ISO Abbreviation: Eur. J. Endocrinol. Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-11-25 Completed Date: 2009-12-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9423848 Medline TA: Eur J Endocrinol Country: England |
Other Details:
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Languages: eng Pagination: 819-28 Citation Subset: IM |
Affiliation:
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Department of Oncology, Barts and the London NHS Trust, West Smithfield, London EC1A 7BE, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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ACTH-Secreting Pituitary Adenoma
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surgery Adenoma / surgery Adult Aged Female Growth Hormone-Secreting Pituitary Adenoma / surgery Human Growth Hormone / blood Humans Insulin-Like Growth Factor I / metabolism Male Middle Aged Pituitary Neoplasms / radiotherapy, surgery* Prolactinoma / surgery Radiosurgery* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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12629-01-5/Human Growth Hormone; 67763-96-6/Insulin-Like Growth Factor I |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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