Combined surgery and radiotherapy of invasive pituitary adenomas--problems of radiogenic encephalopathy.
The aim of the present study was to find out: can combined modality of surgery and local irradiation in case of invasive pituitary adenomas prevent tumour relapse and develop radiogenic late damage after this therapy. Thirty-three patients suffered from primary hypophysomas and twenty-three patients had pituitary tumour recurrences. In all cases combined therapy was performed. The long term results of 56 patients showed a recurrence rate of 5.4% (3 cases). The median follow-up time was 152 months, ranging from 101 to 197 months. Clinical and neuroradiological signs of radiogenic encephalopathy developed in 16 cases (28%). Because of slow progression, the exact beginning of the neurological symptoms was difficult to determine and varied from 7 to 11 years. The extent of the cerebral and endocrinological disturbances was very different but a marked effect of the optic nerve was not seen. It seems that the usual X-ray therapy with single doses of 1.8 Gy and total doses of 45-50 Gy have a high risk of radiogenic morbidity.
Rauhut
F
F
Department of Neurosurgery, University Hospital Essen, Federal Republic of Germany.
Stolke
D
D
D000236:Adenoma / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology / Q000528:radiation effects*; D001925:Brain Damage, Chronic / Q000175:diagnosis; D003131:Combined Modality Therapy; D003480:Cushing Syndrome / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007016:Hypophysectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D010910:Pituitary Irradiation; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D015175:Prolactinoma / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D011832:Radiation Injuries / Q000175:diagnosis*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012306:Risk; D014057:Tomography, X-Ray Computed