Radiat Oncol J.  2016 Jun;34(2):121-127. 10.3857/roj.2016.01683.

Long-term outcomes of surgery and radiotherapy for secreting and non-secreting pituitary adenoma

• Kim MY
• Kim JH
• Oh YK
• Kim E

• KMID: 2327385
• DOI: http://doi.org/10.3857/roj.2016.01683

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.

Keyword

Pituitary adenoma; Radiotherapy; Treatment outcome; Complication

MeSH Terms

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
Adrenocorticotropic Hormone
Growth Hormone
Prolactin