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Outcome of radiotherapy for pituitary adenomas
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Abstract
Aim
The aim of this study was to analyze the outcome and toxicities and its correlation to patient related and treatment related factors.
Background
Pituitary adenomas are treated by radiation therapy (RT) as one of the modalities along with surgery and medical therapy. RT to pituitary adenomas is a challenge due to adjacent dose limiting structures such as optic apparatus and hypothalamus.
Materials and methods
Between January 2004 and December 2010, 94 patients treated for pituitary adenoma with RT who had hospital records of a minimum follow-up of 1 year were included in the analysis. Tests of correlation were done with regards to treatment factors.
Results
Male preponderance was noted in our patient population. Nonfunctioning and functioning tumors were equal in number in this series. Hypopituitarism was associated in 58.5% of patients prior to RT. Radiological tumor progression was seen in one patient (1/94) who had a nonfunctioning tumor. Among functioning tumors, biochemical remission was seen in 93.6% of patients at a median follow-up of 6 years.
Conclusions
Visual complication was seen in 5.3% of patients and worsening or new onset hypopituitarism was seen in 6.4%. Conventional 3-field technique was associated with significantly more visual complication compared to Stereotactic Radiation Therapy (SRT) technique. Doses ≤50.4[[ce:hsp sp="0.25"/]]Gy showed a trend of reduced rate of visual and endocrine complications with no compromise in efficacy.
Abstract
Aim
The aim of this study was to analyze the outcome and toxicities and its correlation to patient related and treatment related factors.
Background
Pituitary adenomas are treated by radiation therapy (RT) as one of the modalities along with surgery and medical therapy. RT to pituitary adenomas is a challenge due to adjacent dose limiting structures such as optic apparatus and hypothalamus.
Materials and methods
Between January 2004 and December 2010, 94 patients treated for pituitary adenoma with RT who had hospital records of a minimum follow-up of 1 year were included in the analysis. Tests of correlation were done with regards to treatment factors.
Results
Male preponderance was noted in our patient population. Nonfunctioning and functioning tumors were equal in number in this series. Hypopituitarism was associated in 58.5% of patients prior to RT. Radiological tumor progression was seen in one patient (1/94) who had a nonfunctioning tumor. Among functioning tumors, biochemical remission was seen in 93.6% of patients at a median follow-up of 6 years.
Conclusions
Visual complication was seen in 5.3% of patients and worsening or new onset hypopituitarism was seen in 6.4%. Conventional 3-field technique was associated with significantly more visual complication compared to Stereotactic Radiation Therapy (SRT) technique. Doses ≤50.4[[ce:hsp sp="0.25"/]]Gy showed a trend of reduced rate of visual and endocrine complications with no compromise in efficacy.
Keywords
Radiotherapy; Pituitary; Complications; Visual; Hypopituitarism; RT; CT; MRI; GH; ACTH; FSH; MV; SRT; 3DCRT; GTC; SPSS; CR; SD; PR; Gy; cGy; SRS; FSRT
About this articleTitle
Outcome of radiotherapy for pituitary adenomas
Journal
Reports of Practical Oncology and Radiotherapy
Issue
Pages
466-472
Published online
2016-09-01
DOI
10.1016/j.rpor.2016.06.002
Bibliographic record
Rep Pract Oncol Radiother 2016;21(5):466-472.
Keywords
Radiotherapy
Pituitary
Complications
Visual
Hypopituitarism
RT
CT
MRI
GH
ACTH
FSH
MV
SRT
3DCRT
GTC
SPSS
CR
SD
PR
Gy
cGy
SRS
FSRT
Authors
Patricia Sebastian
Rajesh Balakrishnan
Bijesh Yadav
Subhashini John