Outcome of fractionated stereotactic radiotherapy in patients with pituitary adenomas resistant to conventional treatments: a 5·25-year follow-up study

• Published in: Clinical endocrinology (Oxford) 2010-07, Vol.73 (1), p.72-77
• Main Authors: Schalin-Jäntti, Camilla, Valanne, Leena, Tenhunen, Mikko, Setälä, Kirsi, Paetau, Anders, Sane, Timo, Kouri, Mauri
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Endocrinopathies; Fundamental and applied biological sciences. Psychology; Hypothalamus. Hypophysis. Epiphysis (diseases); Medical sciences; Miscellaneous; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Public health. Hygiene; Public health. Hygiene-occupational medicine; Vertebrates: endocrinology
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/j.1365-2265.2009.03755.x

Summary Objective  To investigate the long‐term outcome of fractionated stereotactic radiotherapy (FSRT) [45 Gy (range 45–54) in 25 fractions] in patients with pituitary adenomas characterized by tumour progression or hormonally active disease despite surgery and/or medical therapy. Design  This was an observational follow‐up study of 5·25 years (median; range 1·7–10·4). Patients and measurements  Pituitary tumour volume, visual acuity/fields, hypersecretion, hypopituitarism, cerebrovascular disease, second brain tumours and mortality were examined at regular intervals after FSRT in 30 patients with pituitary adenomas (20 nonfunctioning macroadenomas, 10 functioning). Prior to FSRT, 83% had been operated 1–3 times, 47% had visual field deficits/impaired vision and 50% pituitary dysfunction. Progressive disease, stable disease, partial and complete tumour response were defined by MRI. Results  Tumour growth control was 100%. At the end of follow‐up, 30% had stable disease, 60% partial and 10% complete tumour response. Visual function was preserved and 36% of patients with prior field deficits improved. GH decreased from 4·2 (range, 2·3–6·5) to 1·1 (range, 0·5–1·5) μg/l (P