Gamma Knife radiosurgery is very effective in controlling pituitary adenomas, according to a presentation at the American Association of Neurological Surgeons (AANS) annual meeting being held May 1-5 in Philadelphia.
Dr. Jason Sheehan, Ph.D., co-director of the University of Virginia Health System's Gamma Knife Center in Charlottesville, told attendees that the efficacy of Gamma Knife radiosurgery for 418 patients was evaluated. The outcomes of patients were evaluated for a minimum of six months and a median of 31 months.
Tumor control was achieved in 90.3% of the patients, with a higher radiation dose significantly resulting in tumor shrinkage. Sheehan reported that the median time to endocrine remission was 48.9 months for patients with a secretory pituitary adenoma such as in Cushing's disease or acromegaly. In this situation, a higher radiation dose correlated with a faster time to endocrine remission.
Smaller adenoma size correlated with improved endocrine response in patients with secretory adenomas. Temporarily halting pituitary suppressive medications at the time of radiosurgery led to an improvement in endocrine response.
Almost 25% of the patients had new onset of a pituitary hormone deficiency; in particular, thyroid and growth hormone. These patients were prescribed hormone supplementation.
Because radiosurgery offers a high rate of tumor and endocrine control, its use enables most patients to avoid repeat treatment, open surgery, or expensive medical management, Sheehan said.
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Gamma Knife provides local control for some low-grade gliomas, December 23, 2008
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