Gamma Knife Radiosurgery for Functioning Pituitary Microadenoma

Kim, M.S.; Lee, S.I.; Sim, J.H.

doi:10.1159/000056447

Cited by 55 publications

(30 citation statements)

References 4 publications

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“…Witt et al 51 reviewed 20 different radiosurgery studies published between 1997 and 2002 and found that tumor control ranged from 68 to 100% (but most studies showed Ͼ 90% growth control). He also found endocrine improvement in 0 16,29,53,54 to 67%, 35 depending on the study. The endocrine cure in the different studies ranged from 0 16,36 to 96%.…”

Section: Acromegalymentioning

confidence: 89%

“…He also found endocrine improvement in 0 16,29,53,54 to 67%, 35 depending on the study. The endocrine cure in the different studies ranged from 0 16,36 to 96%. 54 …”

Section: Acromegalymentioning

confidence: 89%

“…Tumor control is achieved in most studies in Ͼ 90% of cases, 29,36,43,54 with the exception of 1 study in which only a 68% growth control rate was reported. 16 Cure after radiosurgery was difficult to assess because persistent mild hypersecretion of prolactin may have developed in many patients due to the radiation-induced destruction of the stalk, and therefore to the inhibitory effect of dopaminergic neurons.…”

Section: Prolactin-secreting Adenomasmentioning

confidence: 99%

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Radiation therapy in the treatment of pituitary tumors

Ghostine

Johnson³

2008

FOC

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✓ The treatment of pituitary tumors has progressed into a multidisciplinary approach that involves neurosurgeons, radiation oncologists, and endocrinologists. This has allowed improved outcomes in treatment of pituitary tumors due to a combination of surgical, medical, and radiation therapies. In this study, the authors review the role of radiation therapy in the treatment of pituitary adenomas.

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Section: Acromegalymentioning

confidence: 89%

“…He also found endocrine improvement in 0 16,29,53,54 to 67%, 35 depending on the study. The endocrine cure in the different studies ranged from 0 16,36 to 96%. 54 …”

Section: Acromegalymentioning

confidence: 89%

Section: Prolactin-secreting Adenomasmentioning

confidence: 99%

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Radiation therapy in the treatment of pituitary tumors

Ghostine

Johnson³

2008

FOC

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“…19,28,32,39,43,44,57,61,71,72,77,82,89 The beam trajectories were calculated to spare critical structures near the pituitary adenoma, such as the optic chiasm.…”

Section: Introduction To Stereotactic Radiosurgerymentioning

confidence: 99%

Radiation treatment strategies for acromegaly

Rowland

Aghi²

2010

FOC

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The high morbidity and mortality associated with acromegaly can be addressed with multiple treatment modalities, including surgery, medicines, and radiation therapy. Radiation was initially delivered through conventional fractionated radiotherapy, which targets a wide area over many treatment sessions and has been shown to induce remission in 50%–60% of patients with acromegaly. However, conventional fractionated radiotherapy takes several years to achieve remission in patients with acromegaly and carries a risk of hypopituitarism that may limit its use. Stereotactic radiosurgery, of which there are several forms, including Gamma Knife surgery, CyberKnife therapy, and proton beam therapy, offers slightly attenuated efficacy but achieves remission in less time and provides more precise targeting of the adenoma with better control of the dose of radiation received by adjacent structures such as the pituitary stalk, pituitary gland, optic chiasm, and cranial nerves in the cavernous sinus. Of the forms of stereotactic radiosurgery, Gamma Knife surgery is the most widely used and, because of its long-term follow-up in clinical studies, is the most likely to compete with medical therapy for first-line adjuvant use after resection. In this review, the authors outline the major modes of radiation therapies in clinical use today, and they critically assess the feasibility of these modalities for acromegaly treatment. Acromegaly is a multisystem disorder that demands highly specialized treatment protocols including neurosurgical and endocrinological intervention. As more efficient forms of pituitary radiation develop, acromegaly treatment options may continue to change with radiation therapies playing a more prominent role.

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“…Whether different functional tumors need different radiation doses is a matter of conjecture requiring larger studies with appropriate controls. The accumulated experience of treating TSH secreting pituitary adenomas with GK is anecdotal as compared to that with other functional adenomas owing to the rarity of the tumor [4]. The important observation of successful treatment of TSH secreting pituitary adenoma using adjuvant low dose GKRS needs further studies with large number of patients and longer follow up before widespread application.…”

mentioning

confidence: 99%