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Radiosurgery and the prevention of regrowth of
incompletely removed nonfunctioning pituitary adenomas
Picozzi P, Losa M, Mortini P, Valle MA, Franzin A, Attuati L, Ferrari da
Passano C, Giovanelli M
Pituitary Unit of the Department of Neurosurgery, Istituto Scientifico San
Raffaele, Universita Vita-Salute, Milano, Italy. picozzi.piero@hsr.it
Object. The authors studied the efficacy of gamma knife radiosurgery (GKS)
in the prevention of regrowth of nonfunctioning pituitary adenomas (NPA).
Methods. One hundred nineteen patients were included in this study and were
divided into two groups.
All patients had undergone surgery in our
department and recurrent or residual adenoma was demonstrated on
postoperative MR imaging.
Group A consisted of 68 patients who were followed
without additional treatment.
Group B was composed of 51 patients who
received GKS within 1 year after microsurgery.
There was no significant
demographic difference between the two groups.
In Group B the mean margin
dose was 16.5 +/- 0.3 Gy (range 13-21 Gy).
Fifty one and one tenth percent
of patients in Group A were recurrence free at 5 years and 89.8% in Group B
(p < 0.001).
In Group B patients, tumor volume decreased from a baseline
value of 2.4 +/- 0.2 cm3 to 1.6 +/- 0.2 cm3 at last follow up (p <
0.001).
Conclusions. The results of this study suggest that GKS is effective
in controlling growth of residual NPA for at least 5 years following initial
maximal surgical debulking compared with no radiation therapy.
Thus, GKS is
recommended after microsurgery when visible tumor can be detected on imaging
studies.
PMID: 15662784 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15662784
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