Nelson's syndrome: single centre experience using the linear accelerator (LINAC) for stereotactic radiosurgery and fractionated stereotactic radiotherapy.
Nelson's syndrome is a unique clinical phenomenon of growth of a pituitary adenoma following bilateral adrenalectomies for the control of Cushing's disease. Primary management is surgical, with limited effective medical therapies available. We report our own institution's series of this pathology managed with radiation: prior to 1990, 12 patients were managed with conventional radiotherapy, and between 1990 and 2007, five patients underwent stereotactic radiosurgery (SRS) and two patients fractionated stereotactic radiotherapy (FSRT), both using the linear accelerator (LINAC). Tumour control was equivocal, with two of the five SRS patients having a reduction in tumour volume, one patient remaining unchanged, and two patients having an increase in volume. In the FSRT group, one patient had a decrease in tumour volume whilst the other had an increase in volume. Treatment related morbidity was low. Nelson's syndrome is a challenging clinical scenario, with a highly variable response to radiation in our series.
Department of Radiation Oncology, The Prince of Wales Cancer Centre, Level 2, High Street, Randwick, NSW 2031, Australia.
Peter J
PJ
Wilson
Department of Radiation Oncology, The Prince of Wales Cancer Centre, Level 2, High Street, Randwick, NSW 2031, Australia. Electronic address: Janet.Williams2@sesiahs.health.nsw.gov.au.
Janet R
JR
Williams
Department of Radiation Oncology, The Prince of Wales Cancer Centre, Level 2, High Street, Randwick, NSW 2031, Australia.
Robert I
RI
Smee
D000293:Adolescent; D000328:Adult; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009347:Nelson Syndrome / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D010315:Particle Accelerators; D016634:Radiosurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
Fractionated stereotactic radiotherapy; Hormonal control; Linear accelerator; Nelson’s syndrome; Secreting pituitary adenoma; Stereotactic radiosurgery