| Role of stereotactic radiosurgery in the management of pituitary adenomas. | |
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MedLine Citation:
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PMID: 20177403 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Trans-sphenoidal neurosurgery is the gold standard treatment for pituitary adenomas, but it can be contraindicated or ineffective. Stereotactic radiosurgery is a procedure aimed at controlling hormone hypersecretion and tumor size of pituitary adenomas. This Review discusses the long-term efficacy and adverse effects of stereotactic radiosurgery with the Gamma Knife((R)) in secreting and nonsecreting pituitary adenomas. Long-term data confirm the antisecretory efficacy of the procedure (about 50% remission in hypersecreting tumors) but also a previously unknown low risk of recurrence (2-10% of cases). The time to remission is estimated to range from 12 to 60 months. The antitumoral efficacy of this treatment against nonsecreting tumors is observed in about 90% of cases. Hypopituitarism is the main adverse effect, observed in 20-40% of cases. Comparisons with conventional fractionated radiotherapy reveal a lower rate of remission with Gamma Knife((R)) radiosurgery, counterbalanced by a more rapid efficacy and a lower rate of hypopituitarism. Short-term follow-up results on stereotactic fractionated radiotherapy suggest a risk of hypopituitarism similar to the one observed with radiosurgery. Therefore, stereotactic radiosurgery is probably still useful to treat some cases of pituitary adenoma, despite the fact that antisecretory drugs, particularly for acromegaly and prolactinomas, are becoming more effective and are well tolerated, thus increasing the probability of success with nonsurgical therapy. |
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Authors:
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Frederic Castinetti; Jean Régis; Henry Dufour; Thierry Brue |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Review Date: 2010-02-23 |
Journal Detail:
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Title: Nature reviews. Endocrinology Volume: 6 ISSN: 1759-5037 ISO Abbreviation: Nat Rev Endocrinol Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-25 Completed Date: 2010-06-18 Revised Date: 2011-07-19 |
Medline Journal Info:
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Nlm Unique ID: 101500078 Medline TA: Nat Rev Endocrinol Country: England |
Other Details:
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Languages: eng Pagination: 214-23 Citation Subset: IM |
Affiliation:
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Centre de Réference des Maladies Rares d'Origine Hypophysaire, Service d'Endocrinologie, Diabète et Maladies Métaboliques, Hôpital de la Timone, Assistance Publique Hôpitaux de Marseille, Rue St Pierre, Université de la Mediterranée, Marseille Cedex 05, France. fredcast@umich.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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classification,
radiotherapy,
surgery* Algorithms Animals Combined Modality Therapy Humans Models, Biological Pituitary Neoplasms / classification, radiotherapy, surgery* Radiosurgery* / methods |
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