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Title: 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 » 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.« less

Authors:
 [1];  [1];  [2];  [3];  [4];  [5];  [1]
  1. Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH (United States)
  2. Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI (United States)
  3. Department of Radiation Oncology, Porter Adventist Hospital, Denver, CO (United States)
  4. Swedish Neuroscience Institute, Swedish Hospital, Seattle, WA (United States)
  5. 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}
}