Postoperative radiation therapy for pituitary adenoma

K. Isobe, M. Ohta, S. Yasuda, T. Uno, R. Hara, N. Machida, N. Saeki, A. Yamaura, Naoyuki Shigematsu, H. Ito

Research output: Contribution to journalArticle

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Abstract

Background. We evaluated the efficacy of postoperative radiation therapy (RT), prognostic factors for local control probability, dose response relationship and treatment sequelae in 75 patients with pituitary adenoma. Materials and methods. A total dose of 48-60 Gy (median: 50 Gy) was delivered with a conventional fractionation schedule after surgery. Of 75 patients, 55 (73%) were followed for more than 5 years and 27 (36%) were followed for more than 10 years with a median of 95 months. Results. Five- and 10-year local control probabilities were 87.1% and 85.0%, respectively. Univariate analysis revealed that age (p = 0.007), tumor volume smaller than 30 cm3 (p = 0.018) and the absence of prolactin secretion (p = 0.003) were significantly favorable prognostic factors for local control probability. After multivariate analysis combining these 3 factors, tumor volume smaller than 30 cm3 (p = 0.017) and age (p = 0.039) were statistically significant. Patients with prolactinoma greater than 30 cm3 showed particularly poor local control rates. No significant improvement of the local control rate was detected with increasing total irradiation doses between 48 and 60 Gy (p = 0.29). The most common side effect was hypopituitarism, and there were no severe sequelae such as optic neuropathy or brain necrosis. Conclusion. Except with prolactinoma, the dose of postoperative RT for pituitary adenoma should not exceed 50 Gy. Large prolactinoma, however, was very difficult to control with the irradiation doses between 50 and 60 Gy. and would be good candidates for stereotactic radiosurgery or stereotactic radiation therapy.

Original languageEnglish
Pages (from-to)135-140
Number of pages6
JournalJournal of Neuro-Oncology
Volume48
Issue number2
DOIs
Publication statusPublished - 2000

Fingerprint

Prolactinoma
Pituitary Neoplasms
Radiotherapy
Tumor Burden
Hypopituitarism
Optic Nerve Diseases
Radiosurgery
Prolactin
Appointments and Schedules
Necrosis
Multivariate Analysis
Brain
Therapeutics

Keywords

  • Pituitary adenoma
  • Postoperative radiotherapy
  • Prognostic factor
  • Prolactin

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neuroscience(all)

Cite this

Isobe, K., Ohta, M., Yasuda, S., Uno, T., Hara, R., Machida, N., ... Ito, H. (2000). Postoperative radiation therapy for pituitary adenoma. Journal of Neuro-Oncology, 48(2), 135-140. https://doi.org/10.1023/A:1006477905230

Postoperative radiation therapy for pituitary adenoma. / Isobe, K.; Ohta, M.; Yasuda, S.; Uno, T.; Hara, R.; Machida, N.; Saeki, N.; Yamaura, A.; Shigematsu, Naoyuki; Ito, H.

In: Journal of Neuro-Oncology, Vol. 48, No. 2, 2000, p. 135-140.

Research output: Contribution to journalArticle

Isobe, K, Ohta, M, Yasuda, S, Uno, T, Hara, R, Machida, N, Saeki, N, Yamaura, A, Shigematsu, N & Ito, H 2000, 'Postoperative radiation therapy for pituitary adenoma', Journal of Neuro-Oncology, vol. 48, no. 2, pp. 135-140. https://doi.org/10.1023/A:1006477905230
Isobe K, Ohta M, Yasuda S, Uno T, Hara R, Machida N et al. Postoperative radiation therapy for pituitary adenoma. Journal of Neuro-Oncology. 2000;48(2):135-140. https://doi.org/10.1023/A:1006477905230
Isobe, K. ; Ohta, M. ; Yasuda, S. ; Uno, T. ; Hara, R. ; Machida, N. ; Saeki, N. ; Yamaura, A. ; Shigematsu, Naoyuki ; Ito, H. / Postoperative radiation therapy for pituitary adenoma. In: Journal of Neuro-Oncology. 2000 ; Vol. 48, No. 2. pp. 135-140.
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AU - Isobe, K.

AU - Ohta, M.

AU - Yasuda, S.

AU - Uno, T.

AU - Hara, R.

AU - Machida, N.

AU - Saeki, N.

AU - Yamaura, A.

AU - Shigematsu, Naoyuki

AU - Ito, H.

PY - 2000

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N2 - Background. We evaluated the efficacy of postoperative radiation therapy (RT), prognostic factors for local control probability, dose response relationship and treatment sequelae in 75 patients with pituitary adenoma. Materials and methods. A total dose of 48-60 Gy (median: 50 Gy) was delivered with a conventional fractionation schedule after surgery. Of 75 patients, 55 (73%) were followed for more than 5 years and 27 (36%) were followed for more than 10 years with a median of 95 months. Results. Five- and 10-year local control probabilities were 87.1% and 85.0%, respectively. Univariate analysis revealed that age (p = 0.007), tumor volume smaller than 30 cm3 (p = 0.018) and the absence of prolactin secretion (p = 0.003) were significantly favorable prognostic factors for local control probability. After multivariate analysis combining these 3 factors, tumor volume smaller than 30 cm3 (p = 0.017) and age (p = 0.039) were statistically significant. Patients with prolactinoma greater than 30 cm3 showed particularly poor local control rates. No significant improvement of the local control rate was detected with increasing total irradiation doses between 48 and 60 Gy (p = 0.29). The most common side effect was hypopituitarism, and there were no severe sequelae such as optic neuropathy or brain necrosis. Conclusion. Except with prolactinoma, the dose of postoperative RT for pituitary adenoma should not exceed 50 Gy. Large prolactinoma, however, was very difficult to control with the irradiation doses between 50 and 60 Gy. and would be good candidates for stereotactic radiosurgery or stereotactic radiation therapy.

AB - Background. We evaluated the efficacy of postoperative radiation therapy (RT), prognostic factors for local control probability, dose response relationship and treatment sequelae in 75 patients with pituitary adenoma. Materials and methods. A total dose of 48-60 Gy (median: 50 Gy) was delivered with a conventional fractionation schedule after surgery. Of 75 patients, 55 (73%) were followed for more than 5 years and 27 (36%) were followed for more than 10 years with a median of 95 months. Results. Five- and 10-year local control probabilities were 87.1% and 85.0%, respectively. Univariate analysis revealed that age (p = 0.007), tumor volume smaller than 30 cm3 (p = 0.018) and the absence of prolactin secretion (p = 0.003) were significantly favorable prognostic factors for local control probability. After multivariate analysis combining these 3 factors, tumor volume smaller than 30 cm3 (p = 0.017) and age (p = 0.039) were statistically significant. Patients with prolactinoma greater than 30 cm3 showed particularly poor local control rates. No significant improvement of the local control rate was detected with increasing total irradiation doses between 48 and 60 Gy (p = 0.29). The most common side effect was hypopituitarism, and there were no severe sequelae such as optic neuropathy or brain necrosis. Conclusion. Except with prolactinoma, the dose of postoperative RT for pituitary adenoma should not exceed 50 Gy. Large prolactinoma, however, was very difficult to control with the irradiation doses between 50 and 60 Gy. and would be good candidates for stereotactic radiosurgery or stereotactic radiation therapy.

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KW - Postoperative radiotherapy

KW - Prognostic factor

KW - Prolactin

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