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.
Clarke
S D
SD
Department of Radiology, Baylor College of Medicine, Houston, TX 77030.
Woo
S Y
SY
Butler
E B
EB
Dennis
W S
WS
Lu
H
H
Carpenter
L S
LS
Chiu
J K
JK
Thornby
J I
JI
Baskin
D S
DS
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