Author :
Abstract
Background: To evaluate treatment outcomes and investigate the effectiveness of radiotherapy in patients diagnosed with pituitary adenoma who received radiotherapy as primary treatment, postoperatively, or due to recurrence after surgery. Materials and Methods: Seventy patients who received radiotherapy for pituitary adenoma—either as primary treatment, postoperative therapy, or after recurrence—between 1979 and 1994 were included in this study. Clinical findings, hormonal profiles, radiological findings, and treatment approaches before and after therapy were evaluated. Local control, overall survival, and complications were determined. Statistical analyses were performed using the Kaplan–Meier method, and the Log-Rank test was used for univariate analyses. Results: Local control and survival: After radiotherapy, recurrence was detected in 8 of the 70 cases. Four patients died. The 5-year overall survival rate for all cases was 94.7%, and the local control rate was 87.4%. Hormonal profile after radiotherapy: Hormone levels were normal in 32 (45.7%) patients, while elevated levels were recorded in 15 (21.5%) patients. Hormonal data were unavailable for 23 (32.8%) patients. At presentation, 34 patients had visual problems; after radiotherapy, symptoms persisted in 13 of them. Of the 8 patients with cranial nerve involvement, improvement was observed in 6 after radiotherapy. In one patient, cranial nerve involvement and subsequent recurrence were detected at the 48th month post-radiotherapy, and the patient died within 3 months. Age, sex, treatment modality, duration of radiotherapy, field size, and head fixation were analyzed as prognostic factors; none were found to be statistically significant for local control or overall survival. Conclusion: Radiotherapy is an effective treatment option among the therapeutic modalities for pituitary adenomas. It should be added to surgical treatment, particularly in macroadenomas, to reduce the risk of recurrence; it is also effective in controlling recurrent cases and can be successfully applied as a primary treatment in inoperable patients or those who refuse surgery
Keywords
Abstract
Background: To evaluate treatment outcomes and investigate the effectiveness of radiotherapy in patients diagnosed with pituitary adenoma who received radiotherapy as primary treatment, postoperatively, or due to recurrence after surgery. Materials and Methods: Seventy patients who received radiotherapy for pituitary adenoma—either as primary treatment, postoperative therapy, or after recurrence—between 1979 and 1994 were included in this study. Clinical findings, hormonal profiles, radiological findings, and treatment approaches before and after therapy were evaluated. Local control, overall survival, and complications were determined. Statistical analyses were performed using the Kaplan–Meier method, and the Log-Rank test was used for univariate analyses. Results: Local control and survival: After radiotherapy, recurrence was detected in 8 of the 70 cases. Four patients died. The 5-year overall survival rate for all cases was 94.7%, and the local control rate was 87.4%. Hormonal profile after radiotherapy: Hormone levels were normal in 32 (45.7%) patients, while elevated levels were recorded in 15 (21.5%) patients. Hormonal data were unavailable for 23 (32.8%) patients. At presentation, 34 patients had visual problems; after radiotherapy, symptoms persisted in 13 of them. Of the 8 patients with cranial nerve involvement, improvement was observed in 6 after radiotherapy. In one patient, cranial nerve involvement and subsequent recurrence were detected at the 48th month post-radiotherapy, and the patient died within 3 months. Age, sex, treatment modality, duration of radiotherapy, field size, and head fixation were analyzed as prognostic factors; none were found to be statistically significant for local control or overall survival. Conclusion: Radiotherapy is an effective treatment option among the therapeutic modalities for pituitary adenomas. It should be added to surgical treatment, particularly in macroadenomas, to reduce the risk of recurrence; it is also effective in controlling recurrent cases and can be successfully applied as a primary treatment in inoperable patients or those who refuse surgery
