Radiation oncogenesis in relation to the treatment of pituitary tumours

Jones, Arthur

doi:10.1111/j.1365-2265.1991.tb03554.x

Cited by 84 publications

(41 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is of note that, in the present as well as in the most recently published series, there is a striking decrease in the frequency of complications such as brain and optic tract damage and the development of brain tumours, as compared with earlier series (21). This implies that the regimens currently in use for delivering irradiation to the pituitary gland (in terms of fractionation and total dose), have no major adverse effects on brain structures.…”

Section: Discussionsupporting

confidence: 47%

Megavoltage pituitary irradiation lowers but seldom leads to safe GH levels in acromegaly: a long-term follow-up study

Thalassinos

Tsagarakis²,

Ioannides³

et al. 1998

European Journal of Endocrinology

View full text Add to dashboard Cite

Radiotherapy (RT) has long been used in the treatment of acromegaly, but confusion regarding the definition of biochemical cure has hampered interpretation of previous reports on the outcome of this treatment. In the present study we present additional data using the currently accepted criteria of biochemical cure in a large group of patients followed up by our department. Forty-six acromegalic patients were treated with external beam megavoltage RT and followed up for a mean of 7.6 years (range 2-22 years). Only four patients had had previous surgical treatment by either transsphenoidal or transfrontal routes. Following RT, mean basal GH levels decreased from 30.9 ng/ml (5-96 ng/ml) to 11.5 ng/ml (1-36 ng/ml) at 10 years of follow up with a further fall to 6.1 ng/ml (1-29 ng/ml) in those patients followed up for more than 10 years. As a result, although mean GH levels of less than 5 ng/ml were achieved in 9/28 (30.1%) at 5 years, 6/19 (31.6%) at 10 years, and in 6/11 (54.5%) of those patients followed up for more than 10 years post-RT, only 0/28 (0%), 7/28 (25%), 4/19 (21%) and 1/11 (1%) achieved GH levels of <2.5 ng/ml at 2, 5, 10 and >10 years following RT. Thus, in the whole series only 10/48 (20.8%) patients showed a decrease of GH level to less than 2.5 ng/ml at their latest follow up. Hypopituitarism as a result of RT was only infrequently observed in this series; gonadal deficiency developed in 12 (26.6%) patients, thyrotrophin (TSH) deficiency in 3 (6.6%) and adrenocorticotrophin deficiency in 2 (4.4%). In conclusion, megavoltage RT is an effective treatment for the control of GH hypersecretion in acromegaly, with a continuing lowering effect for several years following RT, but seldom leads to safe GH levels.

show abstract

Section: Discussionsupporting

confidence: 47%

Megavoltage pituitary irradiation lowers but seldom leads to safe GH levels in acromegaly: a long-term follow-up study

Thalassinos

Tsagarakis²,

Ioannides³

et al. 1998

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…24,25 In a review of the world literature that encompassed 22 years, 16 and 19 cases of meningiomas were noted in irradiated and nonirradiated pituitary patients, respectively, and 18 and 9 cases of gliomas were found in irradiated and nonirradiated pituitary patients, respectively. 26 Also epidemiological studies have shown an association between pituitary adenomas and central nervous system tumors.…”

Section: Discussionmentioning

confidence: 99%

The incidence of cerebrovascular accidents and second brain tumors in patients with pituitary adenoma: a population-based study

Brown

Blanchard

Jethwa

et al. 2014

Neuro-Oncology Practice

View full text Add to dashboard Cite

show abstract

“…Tissue damage in the irradiated field yield side effects that in the brain and CNS may include optic neuritis 7,10 , vasculopathy 6,11 , cognitive and psychological disturbances 4,8 and hypothalamic insufficiency 5,9 . Moreover, due to base pair disruption and deoxyribonucleic acid (DNA) strand alteration, irradiation can produce neoplastic transformation 12 .…”

Section: Discussionmentioning

confidence: 99%

“…For these lesions adjunctive radiation has a clear-cut positive effect maximising cure rates and adjourning the reappearance of symptoms. Radiation therapy can produce side effects such as tissue damage [4][5][6][7][8][9][10][11] and neoplastic transformation 1,12 in the irradiated field. Tumour development after radiotherapy is constantly described as an unusual but invariably serious medium term complication of irradiation 13,14 .…”

mentioning

confidence: 99%

Pilocytic astrocytoma following radiotherapy for craniopharyngioma: case report

Bonilha¹,

Borges

Fernandes

et al. 2000

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

-Administration of fractionated doses of irradiation is part of the adjutant therapy for CNS tumours such as craniopharyngiomas and pituitary adenomas. It can maximise cure rates or expand symptom-free period. Among the adverse effects of radiotherapy, the induction of a new tumour within the irradiated field has been frequently described. The precise clinical features that correlate irradiation and oncogenesis are not completely defined, but some authors have suggested that tumors are radiation induced when they are histologically different from the treated ones, arise in greater frequency in irradiated patients than among normal population and tend to occur in younger people with an unusual aggressiveness. In this article, we report a case of a papillary astrocytoma arising in a rather unusual latency period following radiotherapy for craniopharyngioma.KEY WORDS: pilocytic astrocytoma, radiotherapy adverse-effects, oncogenesis. Astrocitoma pilocítico pós-radioterapia para tratamento de craniofaringioma: relato de casoRESUMO -A administração de doses fracionadas de radiação é parte do tratamento adjuvante de tumores do sistema nervoso central como craniofaringiomas ou adenomas hipofisários. A radioterapia pode aumentar as chances de cura ou expandir o período livre de sintomas. Dentre seus efeitos adversos, é conhecida a possibilidade de aparecimento de novo tumor na região irradiada. Os critérios que definem se um novo tumor é de fato induzido por radiação ainda não são completamente definidos. Adimite-se, no entanto, que se o novo tumor é histologicamente diferente do primeiro, aparece em indivíduos mais jovens e é mais agressivo que o habitual, provavelmente sua origem é devida à oncogênese da irradiação. Descrevemos um caso de astrocitoma pilocítico possivelmente induzido por radioterapia, com surgimento em tempo de latência inesperadamente curto. PALAVRAS-CHAVE: astrocitoma pilocítico, efeitos adversos de radioterapia, oncogênese.

show abstract

Radiation oncogenesis in relation to the treatment of pituitary tumours

Cited by 84 publications

References 98 publications

Megavoltage pituitary irradiation lowers but seldom leads to safe GH levels in acromegaly: a long-term follow-up study

Megavoltage pituitary irradiation lowers but seldom leads to safe GH levels in acromegaly: a long-term follow-up study

The incidence of cerebrovascular accidents and second brain tumors in patients with pituitary adenoma: a population-based study

Pilocytic astrocytoma following radiotherapy for craniopharyngioma: case report

Contact Info

Product

Resources

About