title: Gamma knife in the treatment of pituitary adenomas: results of a single center.
abstract: BACKGROUND
  Gamma Knife (GK) radiosurgery for pituitary adenomas can offer a means of tumor and biologic control with acceptable risk and low complication rates.
  
  
  METHODS
  Retrospective review of all the patients treated at our center with GK for pituitary adenomas from Nov 2003 to June 2011.
  
  
  RESULTS
  We treated a total of 86 patients. Ten were lost to follow-up. Mean follow was 32.8 months. There were 21 (24.4%) growth hormone secreting adenomas (GH), 8 (9.3%) prolactinomas (PRL), 8 (9.3%) adrenocorticotropic hormone secreting (ACTH) adenomas, 2 (2.3%) follicle stimulating hormone/luteinizing hormone secreting (FSH/LH) adenomas, and 47 (54.7%) null cell pituitary adenomas that were treated. Average maximum tumor diameter and volume was 2.21cm and 5.41cm³, respectively. The average dose to the 50% isodose line was 14.2 Gy and 23.6 Gy for secreting and non-secreting adenomas respectively. Mean maximal optic nerve dose was 8.87 Gy. Local control rate was 75 of 76 (98.7%), for those with followup. Thirty-three (43.4%) patients experienced arrest of tumor growth, while 42 (55.2%) patients experienced tumor regression. Of the 39 patients with secreting pituitary tumors, 6 were lost to follow-up. Improved endocrine status occurred in 16 (50.0%), while 14 (43.8%) demonstrated stability of hormone status on continued pre-operative medical management. Permanent complications included: panhypopituitarism (4), hypothyroidism (4), hypocortisolemia (1), diabetes insipidus (1), apoplexy (1), visual field defect (2), and diplopia (1).
  
  
  CONCLUSIONS
  Gamma Knife radiosurgery is a safe and effective means of achieving tumor growth control and endocrine remission/stability in pituitary adenomas.
authors.affiliation: Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada. umzeiler@cc.umanitba.ca
authors.forename: F A
authors.initials: FA
authors.lastname: Zeiler
authors.forename: M
authors.initials: M
authors.lastname: Bigder
authors.forename: A
authors.initials: A
authors.lastname: Kaufmann
authors.forename: P J
authors.initials: PJ
authors.lastname: McDonald
authors.forename: D
authors.initials: D
authors.lastname: Fewer
authors.forename: J
authors.initials: J
authors.lastname: Butler
authors.forename: G
authors.initials: G
authors.lastname: Schroeder
authors.forename: M
authors.initials: M
authors.lastname: West
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D016634:Radiosurgery / Q000009:adverse effects; D012189:Retrospective Studies; D055815:Young Adult