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Stereotactic
Radiosurgery for Pituitary Adenomas: A Review of the Literature
Edward
R. Laws, Jason P. Sheehan, Jonas M. Sheehan,
University of Virginia, Charlottesville, VA [E.R.L.,
J.J., J.A.J.jr, R.O.].
University of Virginia, Box 800-212, Department of Neurological
Surgery, Health Sciences Center, Charlottesville, VA 22908 USA; Tel.:
+1-434-982-3244; Fax: +1-434-243-2954; E-mail: jps2f@virginia.edu
[J.P.S.]. Pennsylvania State University, Hershey, PA, USA
[J.M.S.].
Objective.
Pituitary adenomas are very common neoplasms and represent between 10
and 20% of all primary brain tumors.
Historically, the treatment
armamentarium for pituitary adenomas included medical management,
microsurgery, and fractionated radiotherapy.
More recently,
radiosurgery has emerged as a viable treatment option.
The goal of
this research is to define accurately the efficacy, safety, and role
of radiosurgery for treatment of pituitary adenomas.
Methods. Medical literature databases from 1965 to 2003 were searched for
articles pertaining to pituitary adenomas and stereotactic
radiosurgery.
Each study was evaluated for the number of patients,
radiosurgical parameters (e.g. tumor margin dose), length of
follow-up, tumor growth control rate, complications, and rate of
hormonal normalization in the case of functioning adenomas.
Results. A total of 34 published studies including 1567 patients were reviewed.
Radiosurgery offers a tumor growth control rate of ead differences in
endocrinological criteria utilized for post-radiosurgical assessment.
Thus far, the risks of radiation induced neoplasia and cerebral
vasculopathy associated with radiosurgery appear to be lower than for
fractionated radiation therapy.
The incidence of other serious
complications following radiosurgery is quite low.
Conclusions.
Although surgical resection typically is the primary treatment
modality, stereotactic radiosurgery offers safe and effective
treatment for recurrent or residual pituitary adenomas.
In rare
instances, radiosurgery may be the best initial treatment for patients
with pituitary adenomas.
Refinements in the radiosurgical technique
will likely lead to improved outcomes.
Keywords: acromegaly,
Cushing's disease, Gamma Knife, pituitary adenoma, prolactinoma,
radiosurgery
Copyright
©
2004 Kluwer Academic Publishers.
All rights reserved
Source: http://ipsapp007.kluweronline.com/IPS/content/ext/x/J/5042/I/124/A/20/abstract.htm
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