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Volume 13 Issue 1
Jan.  2022
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LIAN Xin, SHEN Jing, SUN Xiansong, YANG Bo, SUN Yuliang, SHEN Jie, ZHANG Fuquan. Treatment Outcome of Intensity-modulated Radiotherapy for 15 Patients with Giant Pituitary Adenoma[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(1): 117-123. DOI: 10.12290/xhyxzz.2021-0413
Citation: LIAN Xin, SHEN Jing, SUN Xiansong, YANG Bo, SUN Yuliang, SHEN Jie, ZHANG Fuquan. Treatment Outcome of Intensity-modulated Radiotherapy for 15 Patients with Giant Pituitary Adenoma[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(1): 117-123. DOI: 10.12290/xhyxzz.2021-0413
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Treatment Outcome of Intensity-modulated Radiotherapy for 15 Patients with Giant Pituitary Adenoma

  • Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

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  • Corresponding author:

    SHEN Jie, E-mail: shenjie@pumch.cn

  • Received Date: May 23, 2021
  • Accepted Date: July 27, 2021
  • Available Online: November 03, 2021
  • Issue Publish Date: January 29, 2022
    Graphical Abstract
    • Abstract
  •   Objective  To summarize the clinical experience of intensity-modulated radiotherapy(IMRT) for patients with giant pituitary adenoma, and to provide evidence for clinical treatment.
      Methods  The data of patients with giant pituitary adenoma who received 6MV-X IMRT with linear accelerator (prescription dose of 56-60 Gy/28-30 fractions, 5 fractions per week) in the Department of Radiation Oncology of Peking Union Medical College Hospital from October 2012 to October 2018 were reviewed. Treatment outcomes were evaluated by the control rate of tumor growth, remission rate of endocrine hormone, and radiation-related complications.
      Results  A total of 15 patients were included in this study. There were 8 males and 7 females with a median age of 32 years. The control rate of tumor growth was 93.3% (partial response in 11 cases, stable in 3 cases, and development of pituitary carcinoma in 1 case). Among the 7 patients with functional giant pituitary adenoma, 1 patient achieved complete remission of the level of endocrine hormone and 2 patients achieved partial remission. Four patients treated with radiotherapy plus temozolomide achieved partial remission (median remission time was 5 months), and the remission rate and remission time were better than those who did not receive temozolomide. During the follow-up period after radiotherapy, 4 patients were found having newly pituitary dysfunction. There were no new or aggravating visional impairment and visual field defects.
      Conclusion  Intensity-modulated radiotherapy is an effective treatment for giant pituitary adenoma, which can reduce the tumor faster combined with temozolomide.
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    • References (18)
  • [1]
    Maiter D, Delgrange E. Therapy of endocrine disease: the challenges in managing giant prolactinomas[J]. Eur J Endocrinol, 2014, 170: R213-R227. DOI: 10.1530/EJE-14-0013
    [2]
    Iglesias P, Rodríguez Berrocal V, Díez JJ. Giant pituitary adenoma: histological types, clinical features and thera-peutic approaches[J]. Endocrine, 2018, 61: 407-421. DOI: 10.1007/s12020-018-1645-x
    [3]
    Chabot JD, Chakraborty S, Imbarrato G, et al. Evaluation of Outcomes After Endoscopic Endonasal Surgery for Large and Giant Pituitary Macroadenoma: A Retrospective Review of 39 Consecutive Patients[J]. World Neurosurg, 2015, 84: 978-988. DOI: 10.1016/j.wneu.2015.06.007
    [4]
    Juraschka K, Khan OH, Godoy BL, et al. Endoscopic endonasal transsphenoidal approach to large and giant pituitary adenomas: institutional experience and predictors of extent of resection[J]. J Neurosurg, 2014, 121: 75-83.
    [5]
    Sinha S, Sharma BS. Giant pituitary adenomas--an enigma revisited. Microsurgical treatment strategies and outcome in a series of 250 patients[J]. Br J Neurosurg, 2010, 24: 31-39. DOI: 10.3109/02688690903370305
    [6]
    McCormack A, Dekkers OM, Petersenn S, et al. Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016[J]. Eur J Endocrinol, 2018, 178: 265-276. DOI: 10.1530/EJE-17-0933
    [7]
    Minniti G, Flickinger J. The risk/benefit ratio of radiother-apy in pituitary tumors[J]. Best Pract Res Clin Endocrinol Metab, 2019, 33: 101269. DOI: 10.1016/j.beem.2019.04.003
    [8]
    Sakanaka K, Mizowaki T, Hiraoka M. Hiraoka. Dosime-tric advantage of intensity-modulated radiotherapy for whole ventricles in the treatment of localized intracranial germinoma[J]. Int J Radiat Oncol Biol Phys, 2012, 82: e273-e280. DOI: 10.1016/j.ijrobp.2011.04.007
    [9]
    Raggi E, Mosleh-Shirazi MA, Saran FH. An evaluation of conformal and intensity-modulated radiotherapy in whole ventricular radiotherapy for localised primary intracranial germinomas[J]. Clin Oncol (R Coll Radiol), 2008, 20: 253-260. DOI: 10.1016/j.clon.2007.12.011
    [10]
    Minniti G, Scaringi C, Poggi M, et al. Fractionated stereotactic radiotherapy for large and invasive non-functioning pituitary adenomas: long-term clinical outcomes and volumetric MRI assessment of tumor response[J]. Eur J Endocrinol, 2015, 172: 433-441. DOI: 10.1530/EJE-14-0872
    [11]
    Raverot G, Burman P, McCormack A, et al. European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas[J]. Eur J Endocrinol, 2018, 178: G1-G24. DOI: 10.1530/EJE-17-0796
    [12]
    Zhong C, Yin S, Zhou P, et al. Pituitary atypical adenoma or carcinoma sensitive to temozolomide combined with radiation therapy: a case report of early identification and management[J]. Turk Neurosurg, 2014, 24: 963-966. http://www.ncbi.nlm.nih.gov/pubmed/25448217
    [13]
    Kamiya-Matsuoka C, Cachia D, Waguespack SG, et al. Radiotherapy with concurrent temozolomide for the management of extraneural metastases in pituitary carcinoma[J]. Pituitary, 2016, 19: 415-421. DOI: 10.1007/s11102-016-0721-6
    [14]
    Misir Krpan A, Dusek T, Rakusic Z, et al. A Rapid Biochemical and Radiological Response to the Concomitant Therapy with Temozolomide and Radiotherapy in an Aggressive ACTH Pituitary Adenoma[J]. Case Rep Endocrinol, 2017: 2419590. http://europepmc.org/articles/PMC5357528/
    [15]
    Touma W, Hoostal S, Peterson RA, et al. Successful treatment of pituitary carcinoma with concurrent radiation, temozolomide, and bevacizumab after resection[J]. J Clin Neurosci, 2017, 41: 75-77. DOI: 10.1016/j.jocn.2017.02.052
    [16]
    Lian X, Shen J, Gu Z, et al. Intensity-modulated Radiotherapy for Pituitary Somatotroph Adenomas[J]. J Clin Endocrinol Metab, 2020, 105: dgaa651. DOI: 10.1210/clinem/dgz199
    [17]
    Zhao K, Liu XM, Liu D, et al. Fractionated Gamma Knife surgery for giant pituitary adenomas[J]. Clin Neurol Neurosurg, 2016, 150: 139-142. DOI: 10.1016/j.clineuro.2016.09.009
    [18]
    Shimon I, Jallad RS, Fleseriu M, et al. Giant GH-secreting pituitary adenomas: management of rare and aggressive pituitary tumors[J]. Eur J Endocrinol, 2015, 172: 707-713. DOI: 10.1530/EJE-14-1117
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