Treatment of secretory pituitary adenoma with radiation therapy.
A retrospective review of 44 patients with secretory pituitary adenoma treated with radiation therapy (median total dose of 4,500 cGy with a median fraction size of 225 cGy) was performed to analyze response rates and possible variables associated with failure to respond and with complications. The treatment technique used for 75% of the patients was a combination field; an opposed-lateral fields technique was used for the remainder. Median follow-up was 78.5 months, with 59% followed up for more than 60 months and 34% for more than 120 months. Overall survival was 90%, and disease-free survival was 62%. Response rates were 86% for the group with prolactinoma, 67% for the group with acromegaly, and 50% for the group with Cushing disease; the overall response rate was 71%. Findings of suprasellar extension and those from treatment with opposed-lateral fields correlated significantly with failure to respond. A higher percentage of patients with invasive macroadenomas also failed to respond. More complications were found in patients treated with opposed-lateral fields, but the numbers were too small to reach significance. Radiation therapy remains an important adjunct for the treatment of many patients with secretory pituitary adenoma.
Department of Radiology, Baylor College of Medicine, Houston, TX 77030.
S D
SD
Clarke
S Y
SY
Woo
E B
EB
Butler
W S
WS
Dennis
H
H
Lu
L S
LS
Carpenter
J K
JK
Chiu
J I
JI
Thornby
D S
DS
Baskin
D000172:Acromegaly / Q000209:etiology; D000236:Adenoma / Q000378:metabolism / Q000401:mortality / Q000532:radiotherapy*; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000328:Adult; D003480:Cushing Syndrome / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D013006:Growth Hormone / Q000378:metabolism; D006801:Humans; D008297:Male; D010911:Pituitary Neoplasms / Q000378:metabolism / Q000401:mortality / Q000532:radiotherapy*; D015175:Prolactinoma / Q000532:radiotherapy; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate
D000324:Adrenocorticotropic Hormone; D013006:Growth Hormone