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Radiotherapy for pituitary adenomas: Long-term efficacy and toxicity

Abstract

Background: Radiotherapy for pituitary adenomas is an effective treatment but remains controversial due to toxicity concerns. Materials and methods: A retrospective audit of patients referred for radiotherapy during 1974-2003 was conducted, the case records were examined and data linkage to cancer registry and hospital discharge records was performed to assess the overall survival (OS), progression-free survival (PFS) and late effects (hormone deficiency, reduced vision, second cancer and stroke). Results: Three hundred and eighty-five patients had radiotherapy (median 45 Gy). The OS was 74% and 49%, PFS was 97% and 96%, at 10 and 20 years, respectively. No specific factors influenced local control. Additional hormone deficiencies occurred in 19% (ACTH) and 26% (TSH). Actuarial rate optic neuropathy at 10 years was 0.8%. Seventy-eight patients had a stroke, a RR for a matched Scottish population of 1.45 (CI 1.05-1.18, p = 0.03) men and 2.22 (1.56-3.08, p < 0.01) women. Four intra-cranial tumours were identified; 20-year actuarial risk 1.9% (CI 0-2.6%), a RR of 5.65 (0.53-20.77, p = 0.10) men and 9.94 (0.94-36.56, p = 0.04) women. Conclusions: This treatment is effective with good local control rates at 20 years. A significant proportion developed hypo-pituitarism. The risk of optic neuropathy was low  More>>
Authors:
Erridge, Sara C., E-mail: serridge@staffmail.ed.ac.u [Edinburgh Centre for Neuro-Oncology, University of Edinburgh (United Kingdom); Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)]; Conkey, David S; [1]  Stockton, Diane; [2]  Strachan, Mark W.J.; [3]  Statham, Patrick F.X.; Whittle, Ian R; Grant, Robin; [4]  Kerr, Gillian R; [5]  Gregor, Anna; [4]  Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)]
  1. Belfast City Hospital, Northern Ireland Cancer Centre (United Kingdom)
  2. ISD, NHS National Services Scotland, Edinburgh (United Kingdom)
  3. Metabolic Unit, University of Edinburgh (United Kingdom)
  4. Edinburgh Centre for Neuro-Oncology, University of Edinburgh (United Kingdom)
  5. Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)
Publication Date:
Dec 15, 2009
Product Type:
Journal Article
Resource Relation:
Journal Name: Radiotherapy and Oncology; Journal Volume: 93; Journal Issue: 3; Other Information: DOI: 10.1016/j.radonc.2009.09.011; PII: S0167-8140(09)00559-3; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACTH; ADENOMAS; HAZARDS; PATIENTS; RADIOTHERAPY; TOXICITY; TSH; CARCINOMAS; DISEASES; HORMONES; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; ORGANIC COMPOUNDS; PEPTIDE HORMONES; PITUITARY HORMONES; PROTEINS; RADIOLOGY; THERAPY
OSTI ID:
21343479
Country of Origin:
Ireland
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0167-8140; RAONDT; TRN: IE10R0076074357
Availability:
Available from http://dx.doi.org/10.1016/j.radonc.2009.09.011
Submitting Site:
INIS
Size:
page(s) 597-601
Announcement Date:
Oct 28, 2010

Citation Formats

Erridge, Sara C., E-mail: serridge@staffmail.ed.ac.u [Edinburgh Centre for Neuro-Oncology, University of Edinburgh (United Kingdom), Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)], Conkey, David S, Stockton, Diane, Strachan, Mark W.J., Statham, Patrick F.X., Whittle, Ian R, Grant, Robin, Kerr, Gillian R, Gregor, Anna, and Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)]. Radiotherapy for pituitary adenomas: Long-term efficacy and toxicity. Ireland: N. p., 2009. Web. doi:10.1016/j.radonc.2009.09.011.
Erridge, Sara C., E-mail: serridge@staffmail.ed.ac.u [Edinburgh Centre for Neuro-Oncology, University of Edinburgh (United Kingdom), Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)], Conkey, David S, Stockton, Diane, Strachan, Mark W.J., Statham, Patrick F.X., Whittle, Ian R, Grant, Robin, Kerr, Gillian R, Gregor, Anna, &amp; Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)]. Radiotherapy for pituitary adenomas: Long-term efficacy and toxicity. Ireland. https://doi.org/10.1016/j.radonc.2009.09.011
Erridge, Sara C., E-mail: serridge@staffmail.ed.ac.u [Edinburgh Centre for Neuro-Oncology, University of Edinburgh (United Kingdom), Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)], Conkey, David S, Stockton, Diane, Strachan, Mark W.J., Statham, Patrick F.X., Whittle, Ian R, Grant, Robin, Kerr, Gillian R, Gregor, Anna, and Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)]. 2009. "Radiotherapy for pituitary adenomas: Long-term efficacy and toxicity." Ireland. https://doi.org/10.1016/j.radonc.2009.09.011.
@misc{etde_21343479,
title = {Radiotherapy for pituitary adenomas: Long-term efficacy and toxicity}
author = {Erridge, Sara C., E-mail: serridge@staffmail.ed.ac.u [Edinburgh Centre for Neuro-Oncology, University of Edinburgh (United Kingdom), Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)], Conkey, David S, Stockton, Diane, Strachan, Mark W.J., Statham, Patrick F.X., Whittle, Ian R, Grant, Robin, Kerr, Gillian R, Gregor, Anna, and Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom)]}
abstractNote = {Background: Radiotherapy for pituitary adenomas is an effective treatment but remains controversial due to toxicity concerns. Materials and methods: A retrospective audit of patients referred for radiotherapy during 1974-2003 was conducted, the case records were examined and data linkage to cancer registry and hospital discharge records was performed to assess the overall survival (OS), progression-free survival (PFS) and late effects (hormone deficiency, reduced vision, second cancer and stroke). Results: Three hundred and eighty-five patients had radiotherapy (median 45 Gy). The OS was 74% and 49%, PFS was 97% and 96%, at 10 and 20 years, respectively. No specific factors influenced local control. Additional hormone deficiencies occurred in 19% (ACTH) and 26% (TSH). Actuarial rate optic neuropathy at 10 years was 0.8%. Seventy-eight patients had a stroke, a RR for a matched Scottish population of 1.45 (CI 1.05-1.18, p = 0.03) men and 2.22 (1.56-3.08, p < 0.01) women. Four intra-cranial tumours were identified; 20-year actuarial risk 1.9% (CI 0-2.6%), a RR of 5.65 (0.53-20.77, p = 0.10) men and 9.94 (0.94-36.56, p = 0.04) women. Conclusions: This treatment is effective with good local control rates at 20 years. A significant proportion developed hypo-pituitarism. The risk of optic neuropathy was low but risk of stroke increased, particularly in women who had slight increased risk of intra-cranial tumours.}
doi = {10.1016/j.radonc.2009.09.011}
journal = []
issue = {3}
volume = {93}
place = {Ireland}
year = {2009}
month = {Dec}
}