Longterm Outcomes Following Radiotherapy for Pituitary Adenomas

1
Long-term Outcomes Following Radiotherapy for
Pituitary Adenomas
Felicia E. Snead, MD Christopher G. Morris, MS
Robert J. Amdur, MD and William M. Mendenhall, MD
Introduction
Results
Multivariate Analysis Outcome
The 10-year actuarial results are shown in Table
1. Involvement of the sphenoid sinus was found to
be significantly associated with a decreased
10-year cause-specific survival (p 0.0453).
Stereotactic radiotherapy technique (2 or 3
fields vs. stereotactic) noted a trend of
significant increased cause-specific survival
(p0.0775). There was no association with
secretion, extent of surgery, or indication of
radiotherapy (salvage vs. adjuvant). New cases of
hypopituitarism occurred in 35 patients. Of the
100 patients treated, 1 patient suffered vision
loss and 1 patient developed a malignant glioma.
To evaluate long-term local control and toxicity
of pituitary adenomas treated with fractionated
radiotherapy.
Materials and Methods
The records of 100 consecutive patients with
pituitary adenoma treated between 1983 and 2003
were retrospectively reviewed. Forty-one patients
had hormone-secreting tumors and 69 patients were
treated postoperatively (adjuvant). Median
follow-up was 6.7 years (range, 0.6-20.2 years)
for all patients and 6.2 years (range, 2-20.2
years) for living patients. The mean dose
delivered was 45 Gy (range, 43-50.4 Gy).
Actuarial Results
Conclusions
This is one of the most mature series in the
literature to document excellent results with
fractionated radiotherapy for pituitary adenoma.
We recommend 45 Gy at 1.8 Gy using stereotactic
noncoplanar fields.