Intensity-modulated radiotherapy for pituitary adenomas: The preliminary report of Cleveland Clinic experience
Abstract
Purpose: Intensity-modulated radiotherapy (IMRT) is being increasingly used for the treatment of pituitary adenomas. However, there have been few published data on the short- and long-term outcomes of this treatment. This is the initial report of Cleveland Clinic's experience. Methods and Materials: Between February 1998 and December 2003, 34 patients with pituitary adenomas were treated with IMRT. A retrospective chart review was conducted for data analysis. Results: With a median follow-up of 42.5 months, the treatment has proven to be well tolerated, with performance status remaining stable in 90% of patients. Radiographic local control was 89%, and among patients with secretory tumors, 100% had a biochemical response. Only 1 patient required salvage surgery for progressive disease, giving a clinical progression free survival of 97%. The only patient who received more than 46 Gy experienced optic neuropathy 8 months after radiation. Smaller tumor volume significantly correlated with subjective improvements in nonvisual neurologic complaints (p = 0.03), and larger tumor volume significantly correlated with subjective worsening of visual symptoms (p = 0.05). New hormonal supplementation was required for 40% of patients. Younger patients were significantly more likely to require hormonal supplementation (p 0.03). Conclusions: Intensity-modulated radiation therapy is a safe and effectivemore »
- Authors:
-
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH (United States)
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI (United States)
- Department of Radiation Oncology, Porter Adventist Hospital, Denver, CO (United States)
- Swedish Neuroscience Institute, Swedish Hospital, Seattle, WA (United States)
- Department of Endocrinology, Cleveland Clinic, Cleveland, OH (United States)
- Publication Date:
- OSTI Identifier:
- 20850319
- Resource Type:
- Journal Article
- Journal Name:
- International Journal of Radiation Oncology, Biology and Physics
- Additional Journal Information:
- Journal Volume: 67; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2006.08.039; PII: S0360-3016(06)02787-8; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
- Subject:
- 62 RADIOLOGY AND NUCLEAR MEDICINE; ADENOMAS; DATA ANALYSIS; PATIENTS; PERFORMANCE; RADIOTHERAPY; REVIEWS; SURGERY; SYMPTOMS; TOXICITY
Citation Formats
Mackley, Heath B, Reddy, Chandana A. M.S., Lee, S -Y, Harnisch, Gayle A, Mayberg, Marc R, Hamrahian, Amir H, Suh, John H, and Brain Tumor Institute, Cleveland Clinic, Cleveland, OH. Intensity-modulated radiotherapy for pituitary adenomas: The preliminary report of Cleveland Clinic experience. United States: N. p., 2007.
Web. doi:10.1016/j.ijrobp.2006.08.039.
Mackley, Heath B, Reddy, Chandana A. M.S., Lee, S -Y, Harnisch, Gayle A, Mayberg, Marc R, Hamrahian, Amir H, Suh, John H, & Brain Tumor Institute, Cleveland Clinic, Cleveland, OH. Intensity-modulated radiotherapy for pituitary adenomas: The preliminary report of Cleveland Clinic experience. United States. https://doi.org/10.1016/j.ijrobp.2006.08.039
Mackley, Heath B, Reddy, Chandana A. M.S., Lee, S -Y, Harnisch, Gayle A, Mayberg, Marc R, Hamrahian, Amir H, Suh, John H, and Brain Tumor Institute, Cleveland Clinic, Cleveland, OH. 2007.
"Intensity-modulated radiotherapy for pituitary adenomas: The preliminary report of Cleveland Clinic experience". United States. https://doi.org/10.1016/j.ijrobp.2006.08.039.
@article{osti_20850319,
title = {Intensity-modulated radiotherapy for pituitary adenomas: The preliminary report of Cleveland Clinic experience},
author = {Mackley, Heath B and Reddy, Chandana A. M.S. and Lee, S -Y and Harnisch, Gayle A and Mayberg, Marc R and Hamrahian, Amir H and Suh, John H and Brain Tumor Institute, Cleveland Clinic, Cleveland, OH},
abstractNote = {Purpose: Intensity-modulated radiotherapy (IMRT) is being increasingly used for the treatment of pituitary adenomas. However, there have been few published data on the short- and long-term outcomes of this treatment. This is the initial report of Cleveland Clinic's experience. Methods and Materials: Between February 1998 and December 2003, 34 patients with pituitary adenomas were treated with IMRT. A retrospective chart review was conducted for data analysis. Results: With a median follow-up of 42.5 months, the treatment has proven to be well tolerated, with performance status remaining stable in 90% of patients. Radiographic local control was 89%, and among patients with secretory tumors, 100% had a biochemical response. Only 1 patient required salvage surgery for progressive disease, giving a clinical progression free survival of 97%. The only patient who received more than 46 Gy experienced optic neuropathy 8 months after radiation. Smaller tumor volume significantly correlated with subjective improvements in nonvisual neurologic complaints (p = 0.03), and larger tumor volume significantly correlated with subjective worsening of visual symptoms (p = 0.05). New hormonal supplementation was required for 40% of patients. Younger patients were significantly more likely to require hormonal supplementation (p 0.03). Conclusions: Intensity-modulated radiation therapy is a safe and effective treatment for pituitary adenomas over the short term. Longer follow-up is necessary to determine if IMRT confers any advantage with respect to either tumor control or toxicity over conventional radiation modalities.},
doi = {10.1016/j.ijrobp.2006.08.039},
url = {https://www.osti.gov/biblio/20850319},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 67,
place = {United States},
year = {Mon Jan 01 00:00:00 EST 2007},
month = {Mon Jan 01 00:00:00 EST 2007}
}