Adenomas of the pituitary gland and postoperative 3D conformal external beam radiation therapy
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Hellenic Journal of Surgery (2013) 85:4, 235-239
Adenomas of the Pituitary Gland and Postoperative 3D Conformal External Beam Radiation Therapy S. Stylianidou
Abstract Aim-Background: Adenomas of the pituitary gland are defined as microadenomas or macroadenomas. The main
symptoms are hormonal dysfunctions, visual dysfunctions and headache. Treatment modalities include medical management, surgery and external beam radiotherapy (3D EBRT). The risk of recurrence is higher when surgery is not followed by postoperative radiation therapy. Objectives-Methods: During the period 2010-2011, five patients with pituitary adenoma received 3D conformal beam radiotherapy with a multileaf collimator (MLC) on a linear accelerator. Three patients were diagnosed with macroadenoma of the pituitary gland and received 3D conformal EBRT just one month after surgery. The total dose was 45Gy with involved fields. Two patients with microadenoma of the pituitary gland with local recurrence received RT one year after surgery, with a dose of 50.4-54 Gy with involved fields. Results: Post radiotherapy, at 6-month, one and two-year follow-up, the patients who had received 3D EBRT 1 month
after surgery displayed decreased Prolactin and GH secretion, and had normal visual field testing. After radiotherapy, contrast-enhanced MRI of the pituitary gland showed no evidence of recurrence. The patients who were given 3D EBRT (with recurrence) one year after surgery also displayed improvement, but with less of a decrease in ACTH and cortisol secretion. (Sy Cushing) Conclusions: An adenoma of the pituitary gland requires therapy for a longer period of time in terms of medical
management, surgery, and radiotherapy. Surgical management that is immediately followed by 3D EBRT gives better results than surgery alone. The results for patients who receive late post-op RT are less than ideal, and the risk of recurrence in such cases is higher. Key words Pituitary gland tumours, adenomas, 3D conformal external beam radiation therapy
Introduction Pituitary adenomas are non-cancerous tumours that occur in the pituitary gland. Accounting for 10-12% of all intracranial tumours, they are relatively uncommon. Adenomas which exceed 10mm in size are defined as macroadenomas and those smaller than 10mm as microadenomas. Most pituitary adenomas concern microadenomas, with an estimated prevalence of 16.7% [1,2]. S. Stylianidou Radiation Oncologist, MD, AHEPA University General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki Corresponding author: Stylianidou Styliani, Radiation Oncology Department of University General Hospital AHEPA, Medical School, Aristotle University, Thessaloniki E-mail: [email protected] Home address: 10 Samothrakis street, Eleftherio-Kordelio, P.C. 56334 Thessaloniki, Greece, Hospital address: 1 St. Kyriakidi street, 54636, Thessaloniki, Greece Tel.: +30 2310993421, Mobile: 6941677422 Department of Radiation Oncology (AHEPA) Received 13 Jan 2013; Accepted 18 March 2013
Hellenic Journal of Surgery 85
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