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Vol.1 , No. 2, Publication Date: Jul. 7, 2014, Page: 48-56
, the goal of this study is to evaluate the efficacy, safety and role of gamma knife surgery for treatment of secretory pituitary adenomas regarding hormonal and adenoma size control, between mid of 2005 and of 2012, a retrospective analysis of 54 consecutive patients with secretory pituitary adenomas underwent GKS at the International Medical Center (IMC) Cairo-Egypt,10 patients with adrenocorticotrophic hormone secreting adenoma, 24 prolactin secreting adenoma and 20 with growth hormone secreting adenoma. In 25 patients GKS was the secondary to a prior surgery with failure of hormonal control even in addition of medical treatment, in the other 29 the secretory pituitary adenomas not controlled with medical treatment alone,the median follow up period was 28 months (12-84 months), achieving hormonal control was either normalization or marked decline of abnormal hormone level > 50%, radiological tumor size control was either tumor size stabilization or reduction ,among the 54 patients 31 had microadenoma of 1cc volume or less, overall 34 patients (63%) had hormonal control and 51 patients (94%) had tumor size control after GKS, there was direct correlation between tumor size, prescription radiation dose and post-gamma knife hormonal and size control, 29 out of the treated 31 microadenomas cases showed both hormonal and size control, in conclusions gamma knife surgery is safe and effective treatment for secretory pituitary adenomas failed to respond to medical treatment alone or with postsurgical residual or recurrence especially microadenomas.&picture=http://www.aascit.org/aascit/decorators/img/journal/906.jpg)
| [1] | Raef FA Hafez, International Medical Centre- Gamma Knife Centre- Cairo - Egypt. |
| [2] | Magad S. Morgan, International Medical Centre- Gamma Knife Centre- Cairo - Egypt. |
| [3] | Osama M. Fahmy, International Medical Centre- Gamma Knife Centre- Cairo - Egypt. |
Historically the treatment armamentarium for secretory pituitary adenomas included neurosurgery, medical management, fractionated radiotherapy and recently gamma knife surgery (GKS), the goal of this study is to evaluate the efficacy, safety and role of gamma knife surgery for treatment of secretory pituitary adenomas regarding hormonal and adenoma size control, between mid of 2005 and of 2012, a retrospective analysis of 54 consecutive patients with secretory pituitary adenomas underwent GKS at the International Medical Center (IMC) Cairo-Egypt,10 patients with adrenocorticotrophic hormone secreting adenoma, 24 prolactin secreting adenoma and 20 with growth hormone secreting adenoma. In 25 patients GKS was the secondary to a prior surgery with failure of hormonal control even in addition of medical treatment, in the other 29 the secretory pituitary adenomas not controlled with medical treatment alone,the median follow up period was 28 months (12-84 months), achieving hormonal control was either normalization or marked decline of abnormal hormone level > 50%, radiological tumor size control was either tumor size stabilization or reduction ,among the 54 patients 31 had microadenoma of 1cc volume or less, overall 34 patients (63%) had hormonal control and 51 patients (94%) had tumor size control after GKS, there was direct correlation between tumor size, prescription radiation dose and post-gamma knife hormonal and size control, 29 out of the treated 31 microadenomas cases showed both hormonal and size control, in conclusions gamma knife surgery is safe and effective treatment for secretory pituitary adenomas failed to respond to medical treatment alone or with postsurgical residual or recurrence especially microadenomas.
Keywords
Acromegaly, Cushing’s Disease, Prolactinoma, Radiosurgery
Reference
| [01] | LandoltAM Lomax N. Gamma knife radiosurgery for prolactinomas. J Neurosurg. 2000; 93(Suppl 3):14–18. |
| [02] | Laws ER, Jr, Vance ML. Radiosurgery for pituitary tumors and craniopharyngiomas. Neuro-surgClin N Am. 1999; 10:327–336. |
| [03] | Petrovich Z, Jozsef G, Yu C, Apuzzo MLJ. Radiotherapy and stereotactic radiosurgery for pituitary tumors. NeurosurgClin N Am. 2003; 14:147–166. |
| [04] | Sheehan JP, Niranjan A, Sheehan JM, Jane JA Jr, Laws ER, Kondziolka D. Stereotactic radiosurgery for pituitary adenomas: an intermediate review of its safety, efficacy, and role in the neurosurgical treatment armamentarium. J Neurosurg. 2005; 102:678–691. |
| [05] | Friedman RB, Oldfield EH, Nieman LK, Chrousos GP, Doppman JL, Cutler GB Jr, Loriaux DL. Repeat transsphenoidal surgery for Cushing's disease. J Neurosurg. 1989; 71:520–527. |
| [06] | Thorén M, Höybye C, Grenbäck E, Degerblad M, Rähn T, Hulting AL. The role of gamma knife radiosurgery in the management of pituitary adenomas. J Neurooncol. 2001; 54:197–203. |
| [07] | Landolt AM, Haller D, Lomax N, Scheib S, Schubiger O, Siegfried J, Wellis G. Stereotactic radiosurgery for recurrent surgically treated acromegaly: Comparison with fractionated radiotherapy. J Neurosurg. 1998; 88:1002–1008. |
| [08] | Niranjan A, Lunsford LD. Radiosurgery: where we were, are, and may be in the third millennium. Neurosurgery. 2000; 46:531–543. |
| [09] | Landolt AM, Haller D, Lomax N, Scheib S, Schubiger O, Siegfried J, Wellis G. Stereotactic radiosurgery for recurrent surgically treated acromegaly: Comparison with fractionated radiotherapy. J Neurosurg. 1998; 88:1002–1008. |
| [10] | Heng Wan, OhyeChihiroandShubin Yuan; MASEP gamma knife radiosurgery for secretory pituitary adenomas: experience in 347 consecutive cases. J ExpClin Cancer Res. 2009; 28(1): 36. |
| [11] | Castro DJ, 1Soraya AJ Cecílio, 1 and Miguel M Canteras.Radiosurgery for pituitary adenomas: evaluation of its efficacyandsafety.RadiatOncol. 2010; 5: 109. |
| [12] | Ganz JC. In: Gamma Knife Applications in and around the Pituitary Fossa Gamma Knife Surgery A Guide for Referring Physicians. Ganz JC, editor. Wicn, Springer; 1993. |
| [13] | Hayashi M, Izawa M, Hiyama H, Nakamura S, Atsuchi S, Sato H, Nakaya K, Sasaki K, Ochiai T, Kubo O, Hori T, Takakura K. Gamma knife radiosurgery for pituitary adenomas. StereotactFunctNeurosurg. 1999;72:111–118 |
| [14] | Izawa M, Hayashi M, Nakaya K, Satoh H, Ochiai T, Hori T, Takakura K. Gamma Knife radiosurgery for pituitary adenomas. J Neurosurg. 2000; 93(Suppl 3):19–22. |
| [15] | Choi JY, Chang JH, Chang JW, Ha Y, Park YG, Chung SS: Radiological and hormonal responses of functioning pituitary adenomas after gamma knife radiosurgery. Yonsei Med J 2003, 44:602-607. |
| [16] | Sheehan JP, Pouratian N, Steiner L, Laws ER, Vance ML.Gamma Knife surgery for pituitary adenomas: factors related to radiological and endocrine outcomes’ 2011 Feb;114(2):303-9. |
| [17] | Pollock BE, Nippoldt TB, Stafford SL, Foote RL, Abboud CF. Results of stereotactic radiosurgery in patients with hormone-producing pituitary adenomas: factors associated with endocrine normalization. J Neurosurg. 2002; 97:525–530. |
