Radiosurgery for pituitary adenomas

Brada, Michael; Ajithkumar, TV; Minniti, Giuseppe

doi:10.1111/j.1365-2265.2004.02138.x

Cited by 97 publications

(59 citation statements)

References 89 publications

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“…Our mean time to remission was 22 months, which is consistent with the previous reports: 6-36 months after GK (12). In most published series of CD patients treated with conventional radiotherapy (6,8,9), remission usually started after 9 months of treatment, and most patients were in remission within 5 years, suggesting that GK may allow faster remission than conventional radiotherapy in CD.…”

Section: Discussionsupporting

confidence: 81%

“…Nevertheless, it does not appear that somatotrope cells are less radiosensitive than corticotropes since higher margin doses were used to treat patients with Cushing's disease in our study. Note that for both conventional radiotherapy and radiosurgery, previous studies found a faster rate of remission in CD than in acromegaly (3-24 vs 6-36 months respectively) (12).…”

Section: Discussionmentioning

confidence: 99%

“…As reviewed elsewhere (12,13), several authors have detailed their experience with gamma knife (GK) in CD. Endocrinological 'cure' rates varied from 17 to 83%, with highly heterogeneous criteria of remission, and most studies were based on short-term effects of GK (14)(15)(16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

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Gamma knife radiosurgery is a successful adjunctive treatment in Cushing’s disease

Castinetti¹,

Nagai²,

Dufour³

et al. 2007

eur j endocrinol

161

118

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Objective: Though transsphenoidal surgery remains the first-line treatment of Cushing's disease, recurrence occurs frequently. Conventional radiotherapy and anticortisolic drugs both have adverse effects. Stereotactic radiosurgery needs to be evaluated more precisely. The aim of this study was to determine long-term hormonal effects and tolerance of gamma knife (GK) radiosurgery in Cushing's disease. Design: Forty patients with Cushing's disease treated by GK were prospectively studied over a decade, with a mean follow-up of 54.7 months. Eleven of them were treated with GK as a primary treatment. Methods: Radiosurgery was performed at the Department of Functional Neurosurgery of Marseille, France, using the Leksell Gamma Unit B and C models. Median margin dose was 29.5 Gy. Patients were considered in remission if they had normalized 24-h free urinary cortisol and suppression of plasma cortisol after low-dose dexamethasone suppression test. Results: Seventeen patients (42.5%) were in remission after a mean of 22 months (range 12-48 months). The two groups did not differ in terms of initial hormonal levels. Target volume was significantly higher in uncured than in remission group (909.8 vs 443 mm 3 , PZ0.038). We found a significant difference between patients who were on or off anticortisolic drugs at the time of GK (20 vs 48% patients in remission respectively, PZ0.02). Conclusion: With 42% of patients in remission after a median follow-up of 54 months, GK stereotactic radiosurgery, especially as an adjunctive treatment to surgery, may represent an alternative to other therapeutic options in view of their adverse effects.European Journal of Endocrinology 156 91-98

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gamma knife radiosurgery is a successful adjunctive treatment in Cushing’s disease

Castinetti¹,

Nagai²,

Dufour³

et al. 2007

eur j endocrinol

161

118

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“…A median dose of 50.4 Gy (range: 45-60 Gy) was prescribed to the 76.9%-95.2% isodose surface and delivered in 1.8-Gy fractions. The median planning target volume (gross tumour plus 3 mm) was 33.5 cm 3 (range: 3.2-75 cm 3 ).…”

Section: Methodsmentioning

confidence: 99%

“…In retrospective series, immediate postoperative radiotherapy has clearly led to significant improvements in long-term local control. Nevertheless, concerns regarding potential late complications such as brain necrosis and optic nerve injury have limited or delayed the use of radiotherapy 3,4 . Classically, simple three-dimensional conformal plans (often a 3-field technique) were used to treat these central lesions, resulting in significant dose delivery to the temporal lobes and the optic apparatus.…”

Section: Introductionmentioning

confidence: 99%

Fractionated Stereotactic Radiotherapy in the Treatment of Pituitary Macroadenomas

et al. 2008

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BackgroundThe use of fractionated stereotactic radiotherapy (FSRT) has evolved with technical advances in noninvasive immobilization, radiation delivery, and image guidance. The application of FSRT to pituitary tumours is aimed at reducing toxicity through improved dose conformality and reduced treatment margins. The aim of the present paper is to report our own experience and to review the published data on FSRT for pituitary macroadenomas. MethodsBetween September 2000 and October 2005, 13 patients with pituitary macroadenoma underwent FSRT at our institution. In 12 patients, radiotherapy treatment followed surgical resection (transsphenoidal resection in 8, frontal craniotomy in 3, and multiple transsphenoidal resections followed by craniotomy in 1). In 4 patients, the tumours were functional (2 adrenocorticotropic hormone-secreting, 1 prolactinoma, and 1 growth hormone-secreting); the tumours in the remaining patients were clinically non-secretory. Before radiation, 3 patients had panhypopituitarism, and 6 patients had visual field defects. All patients were treated with FSRT using non-coplanar micro-multileaf collimation portals. A median dose of 50.4 Gy (range: 45-60 Gy) was prescribed to the 76.9%-95.2% isodose surface and delivered in 1.8-Gy fractions. The median planning target volume (gross tumour plus 3 mm) was 33.5 cm 3 (range: 3.2-75 cm 3 ). ResultsAfter a median follow-up of 24 months (range: 6-60 months), local control was 100%. One patient achieved clinical complete response. Treatment was well tolerated acutely for all patients. Neither radiation-induced optic neuropathy nor any radiation-related endocrine dysfunction was observed in our patients. ConclusionsIn accordance with published series, we found FSRT to be safe and effective in the management of large pituitary macroadenomas.

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The efficacy of fractionated radiotherapy and stereotactic radiosurgery for pituitary adenomas

Kong

Lee

Lim

et al. 2007

Cancer

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Polydimethylsiloxanevi–poly(vinylidene fluoride) (PDMSvi–PVDF) composite membranes were prepared using asymmetric PVDF hollow‐fiber membranes as the substrate where a very thin layer of silicone‐based coating material was deposited via a developed dip coating method. The preparation of the composite membranes under various conditions were investigated. In the optimal coating procedure, homogenous and stable oligo‐PDMSvi coating layers as thin as 1–2 μm were successfully deposited on the surface of PVDF membranes. The developed PDMSvi–PVDF composite membranes were applied for separation of a wide variety of volatile organic compounds (benzene, chloroform, acetone, ethyl acetate, and toluene). The results showed that the PDMSvi–PVDF hollow‐fiber composite membranes that had been developed exhibited very high removal efficiency (>96%) for all the VOCs examined under favorable operating conditions. © 2005 Wiley Periodicals, Inc. J Appl Polym Sci, 2006

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Radiosurgery for pituitary adenomas

Cited by 97 publications

References 89 publications

Gamma knife radiosurgery is a successful adjunctive treatment in Cushing’s disease

Gamma knife radiosurgery is a successful adjunctive treatment in Cushing’s disease

Fractionated Stereotactic Radiotherapy in the Treatment of Pituitary Macroadenomas

The efficacy of fractionated radiotherapy and stereotactic radiosurgery for pituitary adenomas

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