[Efficacy of total removal or subtotal removal combined gamma knife radiation on giant pituitary adenoma: a report of 160 cases].
OBJECTIVE
Pituitary adenoma, a kind of familiar benign intracranial tumor, is mainly treated with surgical operation, medication, and radiation. However, the outcome, especially for giant pituitary adenoma, is not very satisfactory. This study was to explore the efficacy of total tumor removal or subtotal tumor removal combined gamma knife radiation on giant pituitary adenoma.


METHODS
Clinical data of 160 giant pituitary adenoma patients were analyzed. Of the 160 patients, 90 received total tumor removal, 70 received subtotal tumor removal combined gamma knife radiation. The symptom improvement, tumor size change, serum hormone concentration, complications after treatment, and so on, of the 2 groups were compared.


RESULTS
At 12 months after treatment, the efficiency rate, recurrence rate, and mortality were 74.4%, 31.1%, and 3.3%, respectively, in total tumor removal group; however, the efficiency rate reached 91.4%, the recurrence rate decreased to 11.4%, and no patients died in combined therapy group. The follow-up results at 24 months after treatment and at present (over 5 years) showed that though the efficiency rate had descended and recurrence rate or mortality had ascended in both groups, the efficacy of combined therapy was obviously better than that of total tumor removal. The decrease of serum hormone concentration was more obvious in combined therapy group than in total tumor removal group at 12 months after treatment. Moreover, total tumor removal group had more serious complications than combined therapy group after treatment.


CONCLUSIONS
Subtotal tumor removal combined gamma knife radiation is better than total tumor removal for giant pituitary adenoma.
Xiao
Qi-Hua
QH
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Huang
Si-Qing
SQ
Mao
Bo-Yong
BY
Li
Guo-Ping
GP
Ju
Yan
Y
D000236:Adenoma / Q000097:blood / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D003919:Diabetes Insipidus / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D013006:Growth Hormone / Q000097:blood; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000097:blood / Q000601:surgery; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000209:etiology; D007016:Hypophysectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010911:Pituitary Neoplasms / Q000097:blood / Q000601:surgery*; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000097:blood / Q000601:surgery; D016634:Radiosurgery / Q000009:adverse effects; D012189:Retrospective Studies
D011388:Prolactin; D013006:Growth Hormone