Effect of Postoperative Radiotherapy on Tumor Growth of Nonfunctioning Pituitary Adenomas

2008 ◽  
Vol 4 (4) ◽  
pp. 401-414
Author(s):  
Monica Gheorghiu
Keyword(s):  
Tumor Growth ◽  
Pituitary Adenomas ◽  
Postoperative Radiotherapy ◽  
Nonfunctioning Pituitary Adenomas

scholarly journals circOMA1-Mediated miR-145-5p Suppresses Tumor Growth of Nonfunctioning Pituitary Adenomas by Targeting TPT1

2019 ◽  
Vol 104 (6) ◽  
pp. 2419-2434 ◽  
Author(s):  
Qiu Du ◽  
Bin Hu ◽  
Yajuan Feng ◽  
Zongming Wang ◽  
Xin Wang ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Pituitary Adenomas ◽  
Nonfunctioning Pituitary Adenomas

Radiosurgery for Nonfunctioning Pituitary Adenomas

Neurosurgery ◽  
2005 ◽  
Vol 56 (4) ◽  
pp. 699-705 ◽  
Author(s):  
Yoshiyasu Iwai ◽  
Kazuhiro Yamanaka ◽  
Katsunobu Yoshioka
Keyword(s):  
Tumor Growth ◽  
Pituitary Adenomas ◽  
Gamma Knife Radiosurgery ◽  
Growth Control ◽  
Cyst Formation ◽  
Morbidity Rate ◽  
Nonfunctioning Pituitary Adenomas ◽  
Long Term Follow Up

Abstract OBJECTIVE: We evaluated the effectiveness of gamma knife radiosurgery in the treatment of nonfunctioning pituitary adenomas. METHODS: Between January 1994 and December 1999, we treated 34 patients with nonfunctioning pituitary adenomas. Thirty-one of these patients were followed for more than 30 months. Their mean age was 52.9 years. All patients underwent resection before radiosurgery. In four patients, treatment was performed with staged radiosurgery. The treatment volume was 0.7 to 36.2 cm3 (median, 2.5 cm3). The treatment dose ranged from 8 to 20 Gy (median, 14.0 Gy) to the tumor margin. In 15 patients (48.4%), the tumor either compressed or was attached to the optic apparatus. The maximum dose to the optic apparatus was from 2 to 11 Gy (median, 8 Gy). RESULTS: Patients were followed for 30 to 108 months (median, 59.8 mo). The tumor size decreased in 18 patients (58.1%), remained unchanged in 9 patients (29.0%), and increased in four patients (12.9%). The 5-year actual tumor growth control rate was 93%. Among patients with tumor growth, two cases were secondary to cyst formation. Two patients (6.5%) required adrenal and thyroid hormonal replacement during the follow-up period after radiosurgery because of radiation-induced endocrinopathy. None of the patients sustained new cranial nerve deficits, which included optic neuropathy. CONCLUSION: In this series, radiosurgery had a high tumor growth control rate during the long-term follow-up period. Furthermore, we observed a low morbidity rate, with endocrinopathies and optic neuropathies. This low rate included even patients in whom the tumor compressed or was attached to the optic apparatus. We emphasize the necessity of long-term follow-up to evaluate late complications.

scholarly journals Low-dose Gamma Knife surgery for nonfunctioning pituitary adenomas

2012 ◽  
Vol 117 (Special_Suppl) ◽  
pp. 84-88 ◽  
Author(s):  
Amr M. N. El-Shehaby ◽  
Wael A. Reda ◽  
Sameh R. Tawadros ◽  
Khaled M. Abdel Karim
Keyword(s):  
Tumor Growth ◽  
Pituitary Adenomas ◽  
Growth Control ◽  
Visual Field Defects ◽  
Nonfunctioning Pituitary Adenomas ◽  
Pituitary Dysfunction ◽  
Hormone Profile ◽  
Visual Improvement ◽  
The Mean

Object The primary concern when performing Gamma Knife surgery for pituitary adenoma is preservation of vision and pituitary function while achieving tumor growth control. Higher prescribed radiation doses are typically correlated with higher incidences of postradiosurgical hormone deficiencies. The goal of the present study was to retrospectively analyze the feasibility of using a lower prescribed radiation dose in the treatment of nonfunctioning pituitary adenomas and the effect of this dose on vision, pituitary function, and tumor growth control. Methods The study was conducted in 38 patients with nonfunctioning pituitary adenomas, who were treated between January 2002 and July 2008. Twenty-one patients were available for follow-up (13 men and 8 women). The mean follow-up period was 44 months (range 24–90 months). Nineteen patients had previously undergone surgery. Pituitary dysfunction developed after surgery in 3 patients. One patient had an abnormal pituitary hormone profile before radiosurgery due to an attack of pituitary apoplexy. Visual field defects were present in 12 patients. The prescribed radiation dose was 12 Gy in all patients. The tumor volume ranged from 0.5 to 11.8 cm3 (mean 4.8 cm3). The maximum dose to the visual pathway was kept below 10 Gy. The mean maximum dose delivered to the visual pathway was 7.9 Gy. Results The patients were followed up for a period of 24 to 90 months (mean 44 months). The size of the tumor decreased in 11 patients (52%) and remained stable in 9 patients (43%). In 1 patient there was tumor growth outside the previous radiation field (on the contralateral side). Among the 12 patients with visual field defects, 9 (75%) experienced an improvement and the remaining patients' vision remained stable. In only 4 patients was the visual improvement associated with tumor shrinkage. The hormone profile remained normal in all patients except for the 4 patients who had pituitary dysfunction before radiosurgery. Conclusions The 12-Gy prescribed dose used in this study seems to be sufficient for producing tumor control while sparing the patient from radiation-induced pituitary dysfunction. In addition, visual improvement was reported in a number of cases. A larger series and longer follow-up are required to confirm these results.

scholarly journals TBR-760, a Dopamine-Somatostatin Compound, Arrests Growth of Aggressive Nonfunctioning Pituitary Adenomas in Mice

Endocrinology ◽  
2020 ◽  
Vol 161 (8) ◽  
Author(s):  
Heather A Halem ◽  
Ute Hochgeschwender ◽  
Jeong Keun Rih ◽  
Richard Nelson ◽  
G Allan Johnson ◽  
...  
Keyword(s):  
Mouse Model ◽  
Tumor Growth ◽  
Pituitary Adenomas ◽  
Messenger Rna ◽  
Expression Profiles ◽  
Primary Cultures ◽  
Nonfunctioning Pituitary Adenomas ◽  
Mouse Tumors ◽  
The Individual

Abstract TBR-760 (formerly BIM-23A760) is a chimeric dopamine (DA)-somatostatin (SST) compound with potent agonist activity at both DA type 2 (D2R) and SST type 2 (SSTR2) receptors. Studies have shown that chimeric DA-SST compounds are more efficacious than individual DA and/or SST analogues, either alone or combined, in inhibiting secretion from primary cultures of human somatotroph and lactotroph tumor cells. Nonfunctioning pituitary adenomas (NFPAs) express both D2R and SSTR2 and, consequently, may respond to TBR-760. We used a mouse model with the pro-opiomelanocortin (POMC) gene knocked out that spontaneously develops aggressive NFPAs. Genomic microarray and DA and SST receptor messenger RNA expression analysis indicate that POMC KO mouse tumors and human NFPAs have similar expression profiles, despite arising from different cell lineages, establishing POMC KO mice as a model for study of NFPAs. Treatment with TBR-760 for 8 weeks resulted in nearly complete inhibition of established tumor growth, whereas tumors from vehicle-treated mice increased in size by 890 ± 0.7%. Comparing TBR-760 with its individual DA and SST components, TBR-760 arrested tumor growth. Treatment with equimolar or 10×-higher doses of the individual SST or DA agonists, either alone or in combination, had no significant effect. One exception was the lower dose of DA agonist that induced modest suppression of tumor growth. Only the chimeric compound TBR-760 arrested tumor growth in this mouse model of NFPA. Further, significant tumor shrinkage was observed in 20% of the mice treated with TBR-760. These results support the development of TBR-760 as a therapy for patients with NFPA.

SURGICAL TREATMENT OF GIANT PITUITARY ADENOMAS

Neurosurgery ◽  
2007 ◽  
Vol 60 (6) ◽  
pp. 993-1004 ◽  
Author(s):  
Pietro Mortini ◽  
Raffaella Barzaghi ◽  
Marco Losa ◽  
Nicola Boari ◽  
Massimo Giovanelli
Keyword(s):  
Tumor Growth ◽  
Pituitary Adenomas ◽  
Protective Role ◽  
Maximum Diameter ◽  
Surgical Removal ◽  
Consecutive Series ◽  
Nonfunctioning Pituitary Adenomas ◽  
Reduce Tumor Volume ◽  
Giant Pituitary Adenomas ◽  
The Mean

Abstract OBJECTIVE Giant pituitary adenomas, defined as those measuring at least 4 cm in maximum diameter, are a therapeutic challenge. We report our experience in a large, consecutive series of patients with giant adenomas. METHODS Between 1990 and 2004, 95 patients with a giant pituitary adenomas underwent surgery at our department. Nonfunctioning pituitary adenoma was the most frequent type (n = 70; 73.7%), whereas hormone-secreting adenomas numbered only 25 (26.3%). The mean age at the time of surgery (±standard error of the mean) was 48.4 ± 1.5 years; there were 66 men (69.5%) and 29 women (20.5%). RESULTS In total, 111 surgical procedures were performed. Of these, 85 approaches (76.6%) were transsphenoidal and 26 (23.4%) were transcranial. Visual improvement occurred in 59 of the 79 patients with preoperative defect who could be evaluated after surgery (74.7%). Radical tumor excision was obtained in 14 patients (14.7%). Adjuvant medical and radiation therapies led to 74.5% (95% confidence interval, 62.7–86.4%) control of tumor growth at 5 years. This was not different in patients with nonfunctioning pituitary adenomas compared with patients with hormone-secreting tumors. In the subgroup of patients with nonfunctioning pituitary adenomas, radiation therapy had a protective role against tumor growth (P < 0.01). CONCLUSION Maximal surgical removal of giant adenomas through the transsphenoidal or transcranial approach, or both, aimed to relieve compression of the optic pathway and reduce tumor volume as much as possible, offers the best chances to control the tumor when followed with adjuvant medical and radiation therapies.

Nonfunctioning pituitary adenomas: association of Ki-67 and HMGA-1 labeling indices with residual tumor growth

2014 ◽  
Vol 156 (3) ◽  
pp. 451-461 ◽  
Author(s):  
Andrej Šteňo ◽  
Jozef Bocko ◽  
Boris Rychlý ◽  
Martin Chorváth ◽  
Peter Celec ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Pituitary Adenomas ◽  
Residual Tumor ◽  
Ki 67 ◽  
Nonfunctioning Pituitary Adenomas

Postsurgical Salvage Radiosurgery for Nonfunctioning Pituitary Adenomas Touching/Compressing the Optic Chiasm: Median 13-Year Postirradiation Imaging Follow-up Results

Neurosurgery ◽  
2018 ◽  
Vol 85 (4) ◽  
pp. 476-485 ◽  
Author(s):  
Masaaki Yamamoto ◽  
Hitoshi Aiyama ◽  
Takao Koiso ◽  
Shinya Watanabe ◽  
Takuya Kawabe ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Pituitary Adenomas ◽  
Growth Control ◽  
Optic Chiasm ◽  
Long Term Results ◽  
Nonfunctioning Pituitary Adenomas ◽  
Tumor Periphery ◽  
Magnetic Resonance Imaging Mri

Abstract BACKGROUND There is little information on long-term outcomes after salvage treatment by either surgery or stereotactic radiosurgery (SRS) for patients with recurrent/residual nonfunctioning pituitary adenomas (NFPAs). OBJECTIVE To reappraise the efficacy and safety of SRS for patients with NFPAs touching/compressing the optic apparatus (OA). METHODS We studied 27 patients (14 females, 13 males; mean age: 61 [range, 19-85] yr) who underwent SRS between 1998 and 2008 for NFPAs with such condition. The median tumor volume was 4.9 (range, 1.8-50.8) cc. To avoid excess irradiation to the OA, the lower part of the tumor was covered with a 50% or a 60% isodose gradient, ie 49% to 98% (mean, 84%; median, 88%) of the entire tumor received the selected doses. Median doses at the tumor periphery/OA were 7.6/11.0 (interquartile range [IQR], 5.8-9.1/10.1-11.8) Gy. RESULTS Seven patients (26%) were confirmed to be deceased due to unrelated diseases at a median post-SRS period of 149 (IQR, 83-158) mo. Follow-up magnetic resonance imaging (MRI) showed tumor growth in 2 patients (7%) at the 11th and 134th post-SRS month; the former underwent surgery and the other SRS. Excluding these 2 patients, the latest follow-up MRI examinations, performed 13 to 238 (median: 168, IQR: 120-180) mo after SRS, showed no size changes in 5 (19%) and shrinkage in 20 (74%) patients. Cumulative incidences of tumor growth control were 96.3% and 91.8% at the 120th and 180th post-SRS month. None of our patients developed subjective symptoms suggesting SRS-induced optic neuropathy or endocrinological impairment. CONCLUSION In patients with NFPAs touching/compressing the OA, SRS achieves good long-term results.

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