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Erschienen in: Reviews in Endocrine and Metabolic Disorders 2/2009

01.06.2009

Modern techniques for pituitary radiotherapy

verfasst von: G. Minniti, D. C. Gilbert, M. Brada

Erschienen in: Reviews in Endocrine and Metabolic Disorders | Ausgabe 2/2009

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Abstract

Radiotherapy (RT) remains an effective treatment for residual or recurrent pituitary adenomas with excellent rates of tumour control and normalisation of excess hormone secretion. The main late toxicity is hypopituitarism: other side effects are rare. We discuss technical developments in the delivery of radiotherapy (stereotactic conformal radiotherapy (SCRT) and stereotactic radiosurgery (SRS)), all aiming to reduce the amount of normal brain receiving significant doses of radiation. We provide a comprehensive review of published data on outcome of conventional fractionated radiotherapy and modern RT techniques. SCRT is a suitable treatment technique for all sizes of pituitary adenoma and efficacy is comparable to conventional RT; the lack of long term follow up means that currently there is no information on potential reduction in the incidence of late radiation induced toxicity. Single fraction SRS can only be safely delivered to small tumours away from critical structures. There is no evidence that it produces faster decline of elevated hormone levels than fractionated treatment and is not associated with lesser morbidity.
Literatur
1.
Zurück zum Zitat Grigsby PW, et al. Prognostic factors and results of surgery and postoperative irradiation in the management of pituitary adenomas. Int J Radiat Oncol Biol Phys 1989;16:1411–7.PubMed Grigsby PW, et al. Prognostic factors and results of surgery and postoperative irradiation in the management of pituitary adenomas. Int J Radiat Oncol Biol Phys 1989;16:1411–7.PubMed
2.
Zurück zum Zitat McCollough W, et al. Long term follow up of radiotherapy for pituitary adenoma: the absence of late recurrence after 4500 cGy. Int J Radiat Oncol Biol Phys 1991;21:607–14.PubMed McCollough W, et al. Long term follow up of radiotherapy for pituitary adenoma: the absence of late recurrence after 4500 cGy. Int J Radiat Oncol Biol Phys 1991;21:607–14.PubMed
3.
Zurück zum Zitat Brada M, et al. The long term efficacy of conservative surgery and radiotherapy in the control of pituitary adenomas. Clin Endocrinol (Oxf) 1993;38 6:571–8.CrossRef Brada M, et al. The long term efficacy of conservative surgery and radiotherapy in the control of pituitary adenomas. Clin Endocrinol (Oxf) 1993;38 6:571–8.CrossRef
4.
Zurück zum Zitat Tsang RW, et al. Radiation therapy for pituitary adenoma: treatment outcome and prognostic factors. Int J Radiat Oncol Biol Phys 1994;30 3:557–65.PubMed Tsang RW, et al. Radiation therapy for pituitary adenoma: treatment outcome and prognostic factors. Int J Radiat Oncol Biol Phys 1994;30 3:557–65.PubMed
5.
Zurück zum Zitat Zierhut D, et al. External radiotherapy of pituitary adenomas. Int J Radiat Oncol Biol Phys 1995;33 2:307–14.PubMed Zierhut D, et al. External radiotherapy of pituitary adenomas. Int J Radiat Oncol Biol Phys 1995;33 2:307–14.PubMed
6.
Zurück zum Zitat Rush S, Cooper PR. Symptom resolution, tumor control, and side effects following postoperative radiotherapy for pituitary macroadenomas. Int J Radiat Oncol Biol Phys 1997;37 5:1031–4.PubMed Rush S, Cooper PR. Symptom resolution, tumor control, and side effects following postoperative radiotherapy for pituitary macroadenomas. Int J Radiat Oncol Biol Phys 1997;37 5:1031–4.PubMed
7.
Zurück zum Zitat Breen P, et al. Radiotherapy for nonfunctional pituitary adenoma: analysis of long-term tumor control. J Neurosurg 1998;89 6:933–8.PubMed Breen P, et al. Radiotherapy for nonfunctional pituitary adenoma: analysis of long-term tumor control. J Neurosurg 1998;89 6:933–8.PubMed
8.
Zurück zum Zitat Gittoes NJ, et al. Radiotherapy for non-function pituitary tumours. Clin Endocrinol (Oxf) 1998;48 3:331–7.CrossRef Gittoes NJ, et al. Radiotherapy for non-function pituitary tumours. Clin Endocrinol (Oxf) 1998;48 3:331–7.CrossRef
9.
Zurück zum Zitat Sasaki R, et al. The efficacy of conventional radiation therapy in the management of pituitary adenoma. Int J Radiat Oncol Biol Phys 2000;47 5:1337–45.PubMed Sasaki R, et al. The efficacy of conventional radiation therapy in the management of pituitary adenoma. Int J Radiat Oncol Biol Phys 2000;47 5:1337–45.PubMed
10.
Zurück zum Zitat Barkan AL, et al. Pituitary irradiation is ineffective in normalizing plasma insulin-like growth factor I in patients with acromegaly [see comments]. J Clin Endocrinol Metab 1997;82 10:3187–91.PubMedCrossRef Barkan AL, et al. Pituitary irradiation is ineffective in normalizing plasma insulin-like growth factor I in patients with acromegaly [see comments]. J Clin Endocrinol Metab 1997;82 10:3187–91.PubMedCrossRef
11.
12.
Zurück zum Zitat Ajithkumar T, Brada M. Stereotactic linear accelerator radiotherapy for pituitary tumors. Treat Endocrinol 2004;3 4:211–6.PubMedCrossRef Ajithkumar T, Brada M. Stereotactic linear accelerator radiotherapy for pituitary tumors. Treat Endocrinol 2004;3 4:211–6.PubMedCrossRef
13.
Zurück zum Zitat Brada M, Ajithkumar TV, Minniti G. Radiosurgery for pituitary adenomas. Clin Endocrinol (Oxf) 2004;61 5:531–43.CrossRef Brada M, Ajithkumar TV, Minniti G. Radiosurgery for pituitary adenomas. Clin Endocrinol (Oxf) 2004;61 5:531–43.CrossRef
14.
Zurück zum Zitat al Mefty O, et al. The long-term side effects of radiation therapy for benign brain tumors in adults [see comments]. J Neurosurg 1990;73 4:502–12.PubMedCrossRef al Mefty O, et al. The long-term side effects of radiation therapy for benign brain tumors in adults [see comments]. J Neurosurg 1990;73 4:502–12.PubMedCrossRef
15.
Zurück zum Zitat Tsang RW, et al. Glioma arising after radiation therapy for pituitary adenoma. A report of four patients and estimation of risk [published erratum appears in Cancer 1994 Jan 15;73 2:492]. Cancer 1993;72 7:2227–33.PubMedCrossRef Tsang RW, et al. Glioma arising after radiation therapy for pituitary adenoma. A report of four patients and estimation of risk [published erratum appears in Cancer 1994 Jan 15;73 2:492]. Cancer 1993;72 7:2227–33.PubMedCrossRef
16.
Zurück zum Zitat McCord MW, et al. Radiotherapy for pituitary adenoma: long-term outcome and sequelae. Int J Radiat Oncol Biol Phys 1997;39 2:437–44.PubMed McCord MW, et al. Radiotherapy for pituitary adenoma: long-term outcome and sequelae. Int J Radiat Oncol Biol Phys 1997;39 2:437–44.PubMed
17.
Zurück zum Zitat Boelaert K, Gittoes NJ. Radiotherapy for non-functioning pituitary adenomas. Eur J Endocrinol 2001;144 6:569–75.PubMedCrossRef Boelaert K, Gittoes NJ. Radiotherapy for non-functioning pituitary adenomas. Eur J Endocrinol 2001;144 6:569–75.PubMedCrossRef
18.
Zurück zum Zitat Brada M, et al. Cerebrovascular mortality in patients with pituitary adenoma. Clin Endocrinol (Oxf) 2002;57 6:713–7.CrossRef Brada M, et al. Cerebrovascular mortality in patients with pituitary adenoma. Clin Endocrinol (Oxf) 2002;57 6:713–7.CrossRef
19.
Zurück zum Zitat Minniti G, et al. Risk of second brain tumor after conservative surgery and radiotherapy for pituitary adenoma: update after an additional 10 years. J Clin Endocrinol Metab 2005;90 2:800–4.PubMedCrossRef Minniti G, et al. Risk of second brain tumor after conservative surgery and radiotherapy for pituitary adenoma: update after an additional 10 years. J Clin Endocrinol Metab 2005;90 2:800–4.PubMedCrossRef
20.
Zurück zum Zitat Gildersleve J, et al. Reproducibility of patient positioning during routine radiotherapy, as assessed by an integrated megavoltage imaging system. Radiother Oncol 1995;35 2:151–60.PubMedCrossRef Gildersleve J, et al. Reproducibility of patient positioning during routine radiotherapy, as assessed by an integrated megavoltage imaging system. Radiother Oncol 1995;35 2:151–60.PubMedCrossRef
21.
Zurück zum Zitat Karger CP, et al. Three-dimensional accuracy and interfractional reproducibility of patient fixation and positioning using a stereotactic head mask system. Int J Radiat Oncol Biol Phys 2001;49 5:1493–504.PubMed Karger CP, et al. Three-dimensional accuracy and interfractional reproducibility of patient fixation and positioning using a stereotactic head mask system. Int J Radiat Oncol Biol Phys 2001;49 5:1493–504.PubMed
22.
Zurück zum Zitat Perks JR, et al. Optimization of stereotactically-guided conformal treatment planning of sellar and parasellar tumors, based on normal brain dose volume histograms. Int J Radiat Oncol Biol Phys 1999;45 2:507–13.PubMed Perks JR, et al. Optimization of stereotactically-guided conformal treatment planning of sellar and parasellar tumors, based on normal brain dose volume histograms. Int J Radiat Oncol Biol Phys 1999;45 2:507–13.PubMed
23.
Zurück zum Zitat Ajithkumar TV, et al. Optimisation of stereotactically-guided conformal radiotherapy of brain tumours based on normal brain dose volume histograms. Radiother Oncol 64:S83. Ajithkumar TV, et al. Optimisation of stereotactically-guided conformal radiotherapy of brain tumours based on normal brain dose volume histograms. Radiother Oncol 64:S83.
24.
Zurück zum Zitat Khoo VS, et al. Comparison of intensity-modulated tomotherapy with stereotactically guided conformal radiotherapy for brain tumors. Int J Radiat Oncol Biol Phys 1999;45 2:415–25.PubMed Khoo VS, et al. Comparison of intensity-modulated tomotherapy with stereotactically guided conformal radiotherapy for brain tumors. Int J Radiat Oncol Biol Phys 1999;45 2:415–25.PubMed
25.
Zurück zum Zitat Kumar S, et al. Treatment accuracy of fractionated stereotactic radiotherapy. Radiother Oncol 2005;74 1:53–9.PubMedCrossRef Kumar S, et al. Treatment accuracy of fractionated stereotactic radiotherapy. Radiother Oncol 2005;74 1:53–9.PubMedCrossRef
26.
Zurück zum Zitat Yu C, et al. Dosimetric comparison of three photon radiosurgery techniques for an elongated ellipsoid target. Int J Radiat Oncol Biol Phys 1999;45 3:817–26.PubMed Yu C, et al. Dosimetric comparison of three photon radiosurgery techniques for an elongated ellipsoid target. Int J Radiat Oncol Biol Phys 1999;45 3:817–26.PubMed
27.
Zurück zum Zitat Tishler RB, et al. Tolerance of cranial nerves of the cavernous sinus to radiosurgery. Int J Radiat Oncol Biol Phys 1993;27 2:215–21.PubMed Tishler RB, et al. Tolerance of cranial nerves of the cavernous sinus to radiosurgery. Int J Radiat Oncol Biol Phys 1993;27 2:215–21.PubMed
28.
Zurück zum Zitat Leber KA, Bergloff J, Pendl G. Dose-response tolerance of the visual pathways and cranial nerves of the cavernous sinus to stereotactic radiosurgery. J Neurosurg 1998;88 1:43–50.PubMed Leber KA, Bergloff J, Pendl G. Dose-response tolerance of the visual pathways and cranial nerves of the cavernous sinus to stereotactic radiosurgery. J Neurosurg 1998;88 1:43–50.PubMed
29.
Zurück zum Zitat Estrada J, et al. The long-term outcome of pituitary irradiation after unsuccessful transsphenoidal surgery in Cushing’s disease [see comments]. N Engl J Med 1997;336 3:172–7.PubMedCrossRef Estrada J, et al. The long-term outcome of pituitary irradiation after unsuccessful transsphenoidal surgery in Cushing’s disease [see comments]. N Engl J Med 1997;336 3:172–7.PubMedCrossRef
30.
Zurück zum Zitat Barrande G, et al. Hormonal and metabolic effects of radiotherapy in acromegaly: long-term results in 128 patients followed in a single center. J Clin Endocrinol Metab 2000;85 10:3779–85.PubMedCrossRef Barrande G, et al. Hormonal and metabolic effects of radiotherapy in acromegaly: long-term results in 128 patients followed in a single center. J Clin Endocrinol Metab 2000;85 10:3779–85.PubMedCrossRef
31.
Zurück zum Zitat Biermasz NR, Dulken HV, Roelfsema F. Postoperative radiotherapy in acromegaly is effective in reducing GH concentration to safe levels. Clin Endocrinol (Oxf) 2000;53 3:321–7.CrossRef Biermasz NR, Dulken HV, Roelfsema F. Postoperative radiotherapy in acromegaly is effective in reducing GH concentration to safe levels. Clin Endocrinol (Oxf) 2000;53 3:321–7.CrossRef
32.
Zurück zum Zitat Minniti G, et al. Long-term follow-up results of postoperative radiation therapy for Cushing’s disease. J Neurooncol 2007;84 1:79–84.PubMedCrossRef Minniti G, et al. Long-term follow-up results of postoperative radiation therapy for Cushing’s disease. J Neurooncol 2007;84 1:79–84.PubMedCrossRef
33.
Zurück zum Zitat Langsenlehner T, et al. Long-term follow-up of patients with pituitary macroadenomas after postoperative radiation therapy: analysis of tumor control and functional outcome. Strahlenther Onkol 2007;183 5:241–7.PubMedCrossRef Langsenlehner T, et al. Long-term follow-up of patients with pituitary macroadenomas after postoperative radiation therapy: analysis of tumor control and functional outcome. Strahlenther Onkol 2007;183 5:241–7.PubMedCrossRef
34.
Zurück zum Zitat Epaminonda P, et al. Efficacy of radiotherapy in normalizing serum IGF-I, acid-labile subunit (ALS) and IGFBP-3 levels in acromegaly. Clin Endocrinol (Oxf) 2001;55 2:183–9.CrossRef Epaminonda P, et al. Efficacy of radiotherapy in normalizing serum IGF-I, acid-labile subunit (ALS) and IGFBP-3 levels in acromegaly. Clin Endocrinol (Oxf) 2001;55 2:183–9.CrossRef
35.
Zurück zum Zitat Minniti G, et al. The long-term efficacy of conventional radiotherapy in patients with GH-secreting pituitary adenomas. Clin Endocrinol (Oxf) 2005;62 2:210–6.CrossRef Minniti G, et al. The long-term efficacy of conventional radiotherapy in patients with GH-secreting pituitary adenomas. Clin Endocrinol (Oxf) 2005;62 2:210–6.CrossRef
36.
Zurück zum Zitat Howlett TA, et al. Megavoltage pituitary irradiation in the management of Cushing’s disease and Nelson’s syndrome: long-term follow-up. Clin Endocrinol (Oxf) 1989;31 3:309–23.CrossRef Howlett TA, et al. Megavoltage pituitary irradiation in the management of Cushing’s disease and Nelson’s syndrome: long-term follow-up. Clin Endocrinol (Oxf) 1989;31 3:309–23.CrossRef
37.
Zurück zum Zitat Littley MD, et al. Long-term follow-up of low-dose external pituitary irradiation for Cushing’s disease. Clin Endocrinol (Oxf) 1990;33 4:445–55.CrossRef Littley MD, et al. Long-term follow-up of low-dose external pituitary irradiation for Cushing’s disease. Clin Endocrinol (Oxf) 1990;33 4:445–55.CrossRef
38.
Zurück zum Zitat Tsagarakis S, et al. Megavoltage pituitary irradiation in the management of prolactinomas: long-term follow-up. Clin Endocrinol (Oxf) 1991;34 5:399–406.CrossRef Tsagarakis S, et al. Megavoltage pituitary irradiation in the management of prolactinomas: long-term follow-up. Clin Endocrinol (Oxf) 1991;34 5:399–406.CrossRef
39.
Zurück zum Zitat Johnston DG, et al. The long-term effects of megavoltage radiotherapy as sole or combined therapy for large prolactinomas: studies with high definition computerized tomography. Clin Endocrinol (Oxf) 1986;24 6:675–85.CrossRef Johnston DG, et al. The long-term effects of megavoltage radiotherapy as sole or combined therapy for large prolactinomas: studies with high definition computerized tomography. Clin Endocrinol (Oxf) 1986;24 6:675–85.CrossRef
40.
Zurück zum Zitat Mehta AE, Reyes FI, Faiman C. Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up. Am J Med 1987;83 1:49–58.PubMedCrossRef Mehta AE, Reyes FI, Faiman C. Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up. Am J Med 1987;83 1:49–58.PubMedCrossRef
41.
Zurück zum Zitat Becker G, et al. Radiation therapy in the multimodal treatment approach of pituitary adenoma. Strahlenther Onkol 2002;178 4:173–86.PubMedCrossRef Becker G, et al. Radiation therapy in the multimodal treatment approach of pituitary adenoma. Strahlenther Onkol 2002;178 4:173–86.PubMedCrossRef
42.
Zurück zum Zitat Brada M, et al. The incidence of cerebrovascular accidents in patients with pituitary adenoma. Int J Radiat Oncol Biol Phys 1999;45 3:693–8.PubMed Brada M, et al. The incidence of cerebrovascular accidents in patients with pituitary adenoma. Int J Radiat Oncol Biol Phys 1999;45 3:693–8.PubMed
43.
Zurück zum Zitat Tomlinson JW, et al. Association between premature mortality and hypopituitarism. West Midlands Prospective Hypopituitary Study Group. Lancet 2001;357 9254:425–31.PubMedCrossRef Tomlinson JW, et al. Association between premature mortality and hypopituitarism. West Midlands Prospective Hypopituitary Study Group. Lancet 2001;357 9254:425–31.PubMedCrossRef
44.
Zurück zum Zitat Erfurth EM, et al. Risk factors for cerebrovascular deaths in patients operated and irradiated for pituitary tumors. J Clin Endocrinol Metab 2002;87 11:4892–9.PubMedCrossRef Erfurth EM, et al. Risk factors for cerebrovascular deaths in patients operated and irradiated for pituitary tumors. J Clin Endocrinol Metab 2002;87 11:4892–9.PubMedCrossRef
45.
Zurück zum Zitat Tsang R, et al. Glioma arising after radiation therapy for pituitary adenoma: a report of four patients and estimation of risk. Cancer 1993;72:2227–33.PubMedCrossRef Tsang R, et al. Glioma arising after radiation therapy for pituitary adenoma: a report of four patients and estimation of risk. Cancer 1993;72:2227–33.PubMedCrossRef
46.
Zurück zum Zitat Brada M, et al. Risk of second brain tumour after conservative surgery and radiotherapy for pituitary adenoma. Br Med J 1992;304 6838:1343–6.CrossRef Brada M, et al. Risk of second brain tumour after conservative surgery and radiotherapy for pituitary adenoma. Br Med J 1992;304 6838:1343–6.CrossRef
47.
Zurück zum Zitat Peace KA, et al. Cognitive dysfunction in patients with pituitary tumour who have been treated with transfrontal or transsphenoidal surgery or medication. Clin Endocrinol (Oxf) 1998;49 3:391–6.CrossRef Peace KA, et al. Cognitive dysfunction in patients with pituitary tumour who have been treated with transfrontal or transsphenoidal surgery or medication. Clin Endocrinol (Oxf) 1998;49 3:391–6.CrossRef
48.
Zurück zum Zitat Guinan EM, et al. Cognitive effects of pituitary tumours and their treatments: two case studies and an investigation of 90 patients. J Neurol Neurosurg Psychiatry 1998;65 6:870–6.PubMedCrossRef Guinan EM, et al. Cognitive effects of pituitary tumours and their treatments: two case studies and an investigation of 90 patients. J Neurol Neurosurg Psychiatry 1998;65 6:870–6.PubMedCrossRef
49.
Zurück zum Zitat Martinez R, et al. Pituitary tumors and gamma knife surgery. Clinical experience with more than two years of follow-up. Stereotact Funct Neurosurg 1998;70 Suppl 1:110–8.PubMedCrossRef Martinez R, et al. Pituitary tumors and gamma knife surgery. Clinical experience with more than two years of follow-up. Stereotact Funct Neurosurg 1998;70 Suppl 1:110–8.PubMedCrossRef
50.
Zurück zum Zitat Pan L, et al. Pituitary adenomas: the effect of gamma knife radiosurgery on tumor growth and endocrinopathies. Stereotact Funct Neurosurg 1998;70 Suppl 1:119–26.PubMedCrossRef Pan L, et al. Pituitary adenomas: the effect of gamma knife radiosurgery on tumor growth and endocrinopathies. Stereotact Funct Neurosurg 1998;70 Suppl 1:119–26.PubMedCrossRef
51.
Zurück zum Zitat Ikeda H, Jokura H, Yoshimoto T. Gamma knife radiosurgery for pituitary adenomas: usefulness of combined transsphenoidal and gamma knife radiosurgery for adenomas invading the cavernous sinus. Radiat Oncol Investig 1998;6 1:26–34.PubMedCrossRef Ikeda H, Jokura H, Yoshimoto T. Gamma knife radiosurgery for pituitary adenomas: usefulness of combined transsphenoidal and gamma knife radiosurgery for adenomas invading the cavernous sinus. Radiat Oncol Investig 1998;6 1:26–34.PubMedCrossRef
52.
Zurück zum Zitat Mokry M, et al. A six year experience with the postoperative radiosurgical management of pituitary adenomas. Stereotact Funct Neurosurg 1999;72 Suppl 1:88–100.PubMedCrossRef Mokry M, et al. A six year experience with the postoperative radiosurgical management of pituitary adenomas. Stereotact Funct Neurosurg 1999;72 Suppl 1:88–100.PubMedCrossRef
53.
Zurück zum Zitat Hayashi M, et al. Gamma Knife radiosurgery for pituitary adenomas. Stereotact Funct Neurosurg 1999;72 Suppl 1:111–8.PubMedCrossRef Hayashi M, et al. Gamma Knife radiosurgery for pituitary adenomas. Stereotact Funct Neurosurg 1999;72 Suppl 1:111–8.PubMedCrossRef
54.
Zurück zum Zitat Izawa M, et al. Gamma knife radiosurgery for pituitary adenomas. J Neurosurg 2000;93 Suppl 3:19–22.PubMed Izawa M, et al. Gamma knife radiosurgery for pituitary adenomas. J Neurosurg 2000;93 Suppl 3:19–22.PubMed
55.
Zurück zum Zitat Wowra B, Stummer W. Efficacy of gamma knife radiosurgery for nonfunctioning pituitary adenomas: a quantitative follow up with magnetic resonance imaging-based volumetric analysis. J Neurosurg 2002;97 5 Suppl:429–32.PubMed Wowra B, Stummer W. Efficacy of gamma knife radiosurgery for nonfunctioning pituitary adenomas: a quantitative follow up with magnetic resonance imaging-based volumetric analysis. J Neurosurg 2002;97 5 Suppl:429–32.PubMed
56.
Zurück zum Zitat Sheehan JP, et al. Radiosurgery for residual or recurrent nonfunctioning pituitary adenoma. J Neurosurg 2002;97 5 Suppl:408–14.PubMed Sheehan JP, et al. Radiosurgery for residual or recurrent nonfunctioning pituitary adenoma. J Neurosurg 2002;97 5 Suppl:408–14.PubMed
57.
Zurück zum Zitat Petrovich Z, et al. Gamma knife radiosurgery for pituitary adenoma: early results. Neurosurgery 2003;53 1:51–9. discussion 59–61.PubMedCrossRef Petrovich Z, et al. Gamma knife radiosurgery for pituitary adenoma: early results. Neurosurgery 2003;53 1:51–9. discussion 59–61.PubMedCrossRef
58.
Zurück zum Zitat Pollock BE, Carpenter PC. Stereotactic radiosurgery as an alternative to fractionated radiotherapy for patients with recurrent or residual nonfunctioning pituitary adenomas. Neurosurgery 2003;53 5:1086–91. discussion 1091–4.PubMedCrossRef Pollock BE, Carpenter PC. Stereotactic radiosurgery as an alternative to fractionated radiotherapy for patients with recurrent or residual nonfunctioning pituitary adenomas. Neurosurgery 2003;53 5:1086–91. discussion 1091–4.PubMedCrossRef
59.
Zurück zum Zitat Losa M, et al. Gamma knife surgery for treatment of residual nonfunctioning pituitary adenomas after surgical debulking. J Neurosurg 2004;100 3:438–44.PubMedCrossRef Losa M, et al. Gamma knife surgery for treatment of residual nonfunctioning pituitary adenomas after surgical debulking. J Neurosurg 2004;100 3:438–44.PubMedCrossRef
60.
Zurück zum Zitat Iwai Y, Yamanaka K, Yoshioka K. Radiosurgery for nonfunctioning pituitary adenomas. Neurosurgery 2005;56 4:699–705. discussion 699–705.PubMedCrossRef Iwai Y, Yamanaka K, Yoshioka K. Radiosurgery for nonfunctioning pituitary adenomas. Neurosurgery 2005;56 4:699–705. discussion 699–705.PubMedCrossRef
61.
Zurück zum Zitat Liscak R, et al. Gamma knife radiosurgery for endocrine-inactive pituitary adenomas. Acta Neurochir (Wien) 2007;149 10:999–1006. discussion 1006.CrossRef Liscak R, et al. Gamma knife radiosurgery for endocrine-inactive pituitary adenomas. Acta Neurochir (Wien) 2007;149 10:999–1006. discussion 1006.CrossRef
62.
Zurück zum Zitat Pollock BE, et al. Gamma knife radiosurgery for patients with nonfunctioning pituitary adenomas: results from a 15-year experience. Int J Radiat Oncol Biol Phys 2008;70 5:1325–9.PubMed Pollock BE, et al. Gamma knife radiosurgery for patients with nonfunctioning pituitary adenomas: results from a 15-year experience. Int J Radiat Oncol Biol Phys 2008;70 5:1325–9.PubMed
63.
Zurück zum Zitat Mingione V, et al. Gamma surgery in the treatment of nonsecretory pituitary macroadenoma. J Neurosurg 2006;104 6:876–83.PubMedCrossRef Mingione V, et al. Gamma surgery in the treatment of nonsecretory pituitary macroadenoma. J Neurosurg 2006;104 6:876–83.PubMedCrossRef
64.
Zurück zum Zitat Thoren M, et al. Stereotactic radiosurgery with the cobalt-60 gamma unit in the treatment of growth hormone-producing pituitary tumors. Neurosurgery 1991;29 5:663–8.PubMedCrossRef Thoren M, et al. Stereotactic radiosurgery with the cobalt-60 gamma unit in the treatment of growth hormone-producing pituitary tumors. Neurosurgery 1991;29 5:663–8.PubMedCrossRef
65.
Zurück zum Zitat Morange-Ramos I, et al. Short-term endocrinological results after gamma knife surgery of pituitary adenomas. Stereotact Funct Neurosurg 1998;70 Suppl 1:127–38.PubMedCrossRef Morange-Ramos I, et al. Short-term endocrinological results after gamma knife surgery of pituitary adenomas. Stereotact Funct Neurosurg 1998;70 Suppl 1:127–38.PubMedCrossRef
66.
Zurück zum Zitat Lim YL, et al. Four years’ experiences in the treatment of pituitary adenomas with gamma knife radiosurgery. Stereotact Funct Neurosurg 1998;70 Suppl 1:95–109.PubMedCrossRef Lim YL, et al. Four years’ experiences in the treatment of pituitary adenomas with gamma knife radiosurgery. Stereotact Funct Neurosurg 1998;70 Suppl 1:95–109.PubMedCrossRef
67.
Zurück zum Zitat Kim MS, Lee SI, Sim JH. Gamma Knife radiosurgery for functioning pituitary microadenoma. Stereotact Funct Neurosurg 1999;72 Suppl 1:119–24.PubMedCrossRef Kim MS, Lee SI, Sim JH. Gamma Knife radiosurgery for functioning pituitary microadenoma. Stereotact Funct Neurosurg 1999;72 Suppl 1:119–24.PubMedCrossRef
68.
Zurück zum Zitat Landolt AM, et al. Stereotactic radiosurgery for recurrent surgically treated acromegaly: comparison with fractionated radiotherapy. J Neurosurg 1998;88 6:1002–8.PubMedCrossRef Landolt AM, et al. Stereotactic radiosurgery for recurrent surgically treated acromegaly: comparison with fractionated radiotherapy. J Neurosurg 1998;88 6:1002–8.PubMedCrossRef
69.
Zurück zum Zitat Inoue HK, et al. Pituitary adenomas treated by microsurgery with or without Gamma Knife surgery: experience in 122 cases. Stereotact Funct Neurosurg 1999;72 Suppl 1:125–31.PubMedCrossRef Inoue HK, et al. Pituitary adenomas treated by microsurgery with or without Gamma Knife surgery: experience in 122 cases. Stereotact Funct Neurosurg 1999;72 Suppl 1:125–31.PubMedCrossRef
70.
Zurück zum Zitat Zhang N, et al. Radiosurgery for growth hormone-producing pituitary adenomas. J Neurosurg 2000;93 Suppl 3:6–9.PubMed Zhang N, et al. Radiosurgery for growth hormone-producing pituitary adenomas. J Neurosurg 2000;93 Suppl 3:6–9.PubMed
71.
Zurück zum Zitat Pollock BE, et al. Results of stereotactic radiosurgery in patients with hormone-producing pituitary adenomas: factors associated with endocrine normalization. J Neurosurg 2002;97 3:525–30.PubMedCrossRef Pollock BE, et al. Results of stereotactic radiosurgery in patients with hormone-producing pituitary adenomas: factors associated with endocrine normalization. J Neurosurg 2002;97 3:525–30.PubMedCrossRef
72.
Zurück zum Zitat Attanasio R, et al. Gamma-knife radiosurgery in acromegaly: a 4-year follow-up study. J Clin Endocrinol Metab 2003;88 7:3105–12.PubMedCrossRef Attanasio R, et al. Gamma-knife radiosurgery in acromegaly: a 4-year follow-up study. J Clin Endocrinol Metab 2003;88 7:3105–12.PubMedCrossRef
73.
Zurück zum Zitat Choi JY, et al. Radiological and hormonal responses of functioning pituitary adenomas after gamma knife radiosurgery. Yonsei Med J 2003;44 4:602–7.PubMed Choi JY, et al. Radiological and hormonal responses of functioning pituitary adenomas after gamma knife radiosurgery. Yonsei Med J 2003;44 4:602–7.PubMed
74.
Zurück zum Zitat Jane JA Jr, Laws ER Jr. The management of non-functioning pituitary adenomas. Neurol India 2003;51 4:461–5.PubMed Jane JA Jr, Laws ER Jr. The management of non-functioning pituitary adenomas. Neurol India 2003;51 4:461–5.PubMed
75.
Zurück zum Zitat Castinetti F, et al. Outcome of gamma knife radiosurgery in 82 patients with acromegaly: correlation with initial hypersecretion. J Clin Endocrinol Metab 2005;90 8:4483–8.PubMedCrossRef Castinetti F, et al. Outcome of gamma knife radiosurgery in 82 patients with acromegaly: correlation with initial hypersecretion. J Clin Endocrinol Metab 2005;90 8:4483–8.PubMedCrossRef
76.
Zurück zum Zitat Gutt B, et al. Gamma-knife surgery is effective in normalising plasma insulin-like growth factor I in patients with acromegaly. Exp Clin Endocrinol Diabetes 2005;113 4:219–24.PubMedCrossRef Gutt B, et al. Gamma-knife surgery is effective in normalising plasma insulin-like growth factor I in patients with acromegaly. Exp Clin Endocrinol Diabetes 2005;113 4:219–24.PubMedCrossRef
77.
Zurück zum Zitat Kobayashi T, et al. Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure? J Neurosurg 2005;102 Suppl:119–23.PubMedCrossRef Kobayashi T, et al. Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure? J Neurosurg 2005;102 Suppl:119–23.PubMedCrossRef
78.
Zurück zum Zitat Jezkova J, et al. Gamma knife radiosurgery for acromegaly—long-term experience. Clin Endocrinol (Oxf) 2006;64 5:588–95.CrossRef Jezkova J, et al. Gamma knife radiosurgery for acromegaly—long-term experience. Clin Endocrinol (Oxf) 2006;64 5:588–95.CrossRef
79.
Zurück zum Zitat Pollock BE, et al. Radiosurgery of growth hormone-producing pituitary adenomas: factors associated with biochemical remission. J Neurosurg 2007;106 5:833–8.PubMedCrossRef Pollock BE, et al. Radiosurgery of growth hormone-producing pituitary adenomas: factors associated with biochemical remission. J Neurosurg 2007;106 5:833–8.PubMedCrossRef
80.
Zurück zum Zitat Degerblad M, et al. Long term results of stereotactic radiosurgery to the pituitary gland in Cushing’s disease. Acta Endocrinol (Copenh) 1986;112 3:310–4. Degerblad M, et al. Long term results of stereotactic radiosurgery to the pituitary gland in Cushing’s disease. Acta Endocrinol (Copenh) 1986;112 3:310–4.
81.
Zurück zum Zitat Ganz JC, Backlund EO, Thorsen FA. The effects of Gamma Knife surgery of pituitary adenomas on tumor growth and endocrinopathies. Stereotact Funct Neurosurg 1993;61 Suppl 1:30–7.PubMed Ganz JC, Backlund EO, Thorsen FA. The effects of Gamma Knife surgery of pituitary adenomas on tumor growth and endocrinopathies. Stereotact Funct Neurosurg 1993;61 Suppl 1:30–7.PubMed
82.
Zurück zum Zitat Seo Y, et al. Gamma knife surgery for Cushing’s disease. Surg Neurol 1995;43 2:170–5. discussion 175–6.PubMedCrossRef Seo Y, et al. Gamma knife surgery for Cushing’s disease. Surg Neurol 1995;43 2:170–5. discussion 175–6.PubMedCrossRef
83.
Zurück zum Zitat Sheehan JM, et al. Radiosurgery for Cushing’s disease after failed transsphenoidal surgery. J Neurosurg 2000;93 5:738–42.PubMedCrossRef Sheehan JM, et al. Radiosurgery for Cushing’s disease after failed transsphenoidal surgery. J Neurosurg 2000;93 5:738–42.PubMedCrossRef
84.
Zurück zum Zitat Hoybye C, et al. Adrenocorticotropic hormone-producing pituitary tumors: 12- to 22-year follow-up after treatment with stereotactic radiosurgery. Neurosurgery 2001;49 2:284–91. discussion 291–2.PubMedCrossRef Hoybye C, et al. Adrenocorticotropic hormone-producing pituitary tumors: 12- to 22-year follow-up after treatment with stereotactic radiosurgery. Neurosurgery 2001;49 2:284–91. discussion 291–2.PubMedCrossRef
85.
Zurück zum Zitat Kobayashi T, Kida Y, Mori Y. Gamma knife radiosurgery in the treatment of Cushing disease: long-term results. J Neurosurg 2002;97 5 Suppl:422–8.PubMed Kobayashi T, Kida Y, Mori Y. Gamma knife radiosurgery in the treatment of Cushing disease: long-term results. J Neurosurg 2002;97 5 Suppl:422–8.PubMed
86.
Zurück zum Zitat Devin JK, et al. The efficacy of linear accelerator radiosurgery in the management of patients with Cushing’s disease. Stereotact Funct Neurosurg 2004;82 5–6:254–62.PubMedCrossRef Devin JK, et al. The efficacy of linear accelerator radiosurgery in the management of patients with Cushing’s disease. Stereotact Funct Neurosurg 2004;82 5–6:254–62.PubMedCrossRef
87.
Zurück zum Zitat Castinetti F, et al. Gamma knife radiosurgery is a successful adjunctive treatment in Cushing’s disease. Eur J Endocrinol 2007;156 1:91–8.PubMedCrossRef Castinetti F, et al. Gamma knife radiosurgery is a successful adjunctive treatment in Cushing’s disease. Eur J Endocrinol 2007;156 1:91–8.PubMedCrossRef
88.
Zurück zum Zitat Jagannathan J, et al. Gamma Knife surgery for Cushing’s disease. J Neurosurg 2007;106 6:980–7.PubMedCrossRef Jagannathan J, et al. Gamma Knife surgery for Cushing’s disease. J Neurosurg 2007;106 6:980–7.PubMedCrossRef
89.
Zurück zum Zitat Landolt AM, Lomax N. Gamma knife radiosurgery for prolactinomas. J Neurosurg 2000;93 Suppl 3:14–8.PubMed Landolt AM, Lomax N. Gamma knife radiosurgery for prolactinomas. J Neurosurg 2000;93 Suppl 3:14–8.PubMed
90.
Zurück zum Zitat Pouratian N, et al. Gamma knife radiosurgery for medically and surgically refractory prolactinomas. Neurosurgery 2006;59 2:255–66. discussion 255–66.PubMedCrossRef Pouratian N, et al. Gamma knife radiosurgery for medically and surgically refractory prolactinomas. Neurosurgery 2006;59 2:255–66. discussion 255–66.PubMedCrossRef
91.
Zurück zum Zitat Pan L, et al. Gamma knife radiosurgery as a primary treatment for prolactinomas. J Neurosurg 2000;93 Suppl 3:10–3.PubMed Pan L, et al. Gamma knife radiosurgery as a primary treatment for prolactinomas. J Neurosurg 2000;93 Suppl 3:10–3.PubMed
92.
Zurück zum Zitat Voges J, et al. LINAC-radiosurgery (LINAC-RS) in pituitary adenomas: preliminary results. Acta Neurochir Suppl (Wien) 1996;65:41–3. Voges J, et al. LINAC-radiosurgery (LINAC-RS) in pituitary adenomas: preliminary results. Acta Neurochir Suppl (Wien) 1996;65:41–3.
93.
Zurück zum Zitat Yoon SC, et al. Clinical results of 24 pituitary macroadenomas with linac-based stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 1998;41 4:849–53.PubMed Yoon SC, et al. Clinical results of 24 pituitary macroadenomas with linac-based stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 1998;41 4:849–53.PubMed
94.
Zurück zum Zitat Mitsumori M, et al. Initial clinical results of LINAC-based stereotactic radiosurgery and stereotactic radiotherapy for pituitary adenomas. Int J Radiat Oncol Biol Phys 1998;42 3:573–80.PubMed Mitsumori M, et al. Initial clinical results of LINAC-based stereotactic radiosurgery and stereotactic radiotherapy for pituitary adenomas. Int J Radiat Oncol Biol Phys 1998;42 3:573–80.PubMed
95.
Zurück zum Zitat Coke C, et al. Multiple fractionated stereotactic radiotherapy of residual pituitary macroadenomas: initial experience. Stereotact Funct Neurosurg 1997;69 1–4 Pt 2:183–90.PubMedCrossRef Coke C, et al. Multiple fractionated stereotactic radiotherapy of residual pituitary macroadenomas: initial experience. Stereotact Funct Neurosurg 1997;69 1–4 Pt 2:183–90.PubMedCrossRef
96.
Zurück zum Zitat Milker-Zabel S, et al. Fractionated stereotactically guided radiotherapy and radiosurgery in the treatment of functional and nonfunctional adenomas of the pituitary gland. Int J Radiat Oncol Biol Phys 2001;50 5:1279–86.PubMed Milker-Zabel S, et al. Fractionated stereotactically guided radiotherapy and radiosurgery in the treatment of functional and nonfunctional adenomas of the pituitary gland. Int J Radiat Oncol Biol Phys 2001;50 5:1279–86.PubMed
97.
Zurück zum Zitat Paek SH, et al. Integration of surgery with fractionated stereotactic radiotherapy for treatment of nonfunctioning pituitary macroadenomas. Int J Radiat Oncol Biol Phys 2005;61 3:795–808.PubMed Paek SH, et al. Integration of surgery with fractionated stereotactic radiotherapy for treatment of nonfunctioning pituitary macroadenomas. Int J Radiat Oncol Biol Phys 2005;61 3:795–808.PubMed
98.
Zurück zum Zitat Colin P, et al. Treatment of pituitary adenomas by fractionated stereotactic radiotherapy: a prospective study of 110 patients. Int J Radiat Oncol Biol Phys 2005;62 2:333–41.PubMed Colin P, et al. Treatment of pituitary adenomas by fractionated stereotactic radiotherapy: a prospective study of 110 patients. Int J Radiat Oncol Biol Phys 2005;62 2:333–41.PubMed
99.
Zurück zum Zitat Minniti G, et al. Fractionated stereotactic conformal radiotherapy for secreting and nonsecreting pituitary adenomas. Clin Endocrinol (Oxf) 2006;64 5:542–8.CrossRef Minniti G, et al. Fractionated stereotactic conformal radiotherapy for secreting and nonsecreting pituitary adenomas. Clin Endocrinol (Oxf) 2006;64 5:542–8.CrossRef
100.
Zurück zum Zitat Selch MT, et al. Stereotactic radiotherapy for the treatment of pituitary adenomas. Minim Invasive Neurosurg 2006;49 3:150–5.PubMedCrossRef Selch MT, et al. Stereotactic radiotherapy for the treatment of pituitary adenomas. Minim Invasive Neurosurg 2006;49 3:150–5.PubMedCrossRef
101.
Zurück zum Zitat Kong DS, et al. The efficacy of fractionated radiotherapy and stereotactic radiosurgery for pituitary adenomas: long-term results of 125 consecutive patients treated in a single institution. Cancer 2007;110 4:854–60.PubMedCrossRef Kong DS, et al. The efficacy of fractionated radiotherapy and stereotactic radiosurgery for pituitary adenomas: long-term results of 125 consecutive patients treated in a single institution. Cancer 2007;110 4:854–60.PubMedCrossRef
Metadaten
Titel
Modern techniques for pituitary radiotherapy
verfasst von
G. Minniti
D. C. Gilbert
M. Brada
Publikationsdatum
01.06.2009
Verlag
Springer US
Erschienen in
Reviews in Endocrine and Metabolic Disorders / Ausgabe 2/2009
Print ISSN: 1389-9155
Elektronische ISSN: 1573-2606
DOI
https://doi.org/10.1007/s11154-008-9106-0

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