Long-term outcomes of surgery and radiotherapy for secreting and non-secreting pituitary adenoma.
- Author:
Mi Young KIM
1
;
Jin Hee KIM
;
Young Kee OH
;
El KIM
Author Information
- Publication Type:Original Article
- Keywords: Pituitary adenoma; Radiotherapy; Treatment outcome; Complication
- MeSH: Adenoma; Adrenocorticotropic Hormone; Cataract; Cavernous Sinus; Diagnosis; Disease-Free Survival; Follow-Up Studies; Growth Hormone; Humans; Pituitary Neoplasms*; Prolactin; Radiotherapy*; Recurrence; Treatment Outcome; Visual Acuity; Visual Fields
- From:Radiation Oncology Journal 2016;34(2):121-127
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To investigate treatment outcome and long term complication after surgery and radiotherapy (RT) for pituitary adenoma. MATERIALS AND METHODS: From 1990 to 2009, 73 patients with surgery and RT for pituitary adenoma were analyzed in this study. Median age was 51 years (range, 25 to 71 years). Median tumor size was 3 cm (range, 1 to 5 cm) with suprasellar (n = 21), cavernous sinus extension (n = 14) or both (n = 5). Hormone secreting tumor was diagnosed in 29 patients; 16 patients with prolactin, 12 patients with growth hormone, and 1 patient with adrenocorticotrophic hormone. Impairment of visual acuity or visual field was presented in 33 patients at first diagnosis. Most patients (n = 64) received RT as postoperative adjuvant setting. Median RT dose was 45 Gy (range, 45 to 59.4 Gy). RESULTS: Median follow-up duration was 8 years (range, 3 to 22 years). In secreting tumors, hormone normalization rate was 55% (16 of 29 patients). For 25 patients with evaluable visual field and visual acuity test, 21 patients (84%) showed improvement of visual disturbance after treatment. The 10-year tumor control rate for non-secreting and secreting adenoma was 100% and 58%, respectively (p < 0.001). Progression free survival rate at 10 years was 98%. Only 1 patient experienced endocrinological recurrence. Following surgery, 60% (n = 44) suffered from pituitary function deficit. Late complication associated with RT was only 1 patient, who developed cataract. CONCLUSION: Surgery and RT are very effective and safe in hormonal and tumor growth control for secreting and non-secreting pituitary adenoma.
