TY - JOUR
T1 - Prognostic factors and results of radiotherapy alone in the management of pituitary adenomas
AU - Grigsby, Perry W.
AU - Stokes, Steven
AU - Marks, James E.
AU - Simpson, Joseph R.
N1 - Funding Information:
regard to secretory products, growth patterns, and response to therapy. The heterogeneity of these tumors continues to be revealed by immunoperoxidase staining of tumor tissue and by current serologic tests. Contemporary studies have disclosed that many pituitary adenomas that were once thought to be “non-functioning” can indeed have hormonal products. Careful evaluation has also verified the presence of mixed tumors.‘6.‘9*21,29 Mass effects produced by pituitary adenomas can include headache and visual field and/or visual acuity changes. Effects resulting from tumor hormone products encompass hypertension and cardiomyopathy in patients with acromegaly, amenorrhea, galactorrhea, infertility, and libido changes can arise from prolactinomas. ACTH-producing tumors (Cushing’s disease) can cause the classic findings of truncal obesity, hypertension, striae, edema, glucosuria, and osteoporosis. Nelson’s syndrome (ACTH-producing pituitary adenomas de- Supported by the American Cancer Society Clinical Oncology Career Development Award. Reprint requests to: Perry W. Grigsby, M.D., Radiation On-
PY - 1988/11
Y1 - 1988/11
N2 - Prognostic factors and results of therapy were analyzed in a retrospective review of 70 patients with pituitary adenomas treated with radiotherapy alone from January 1954 through December 1982 at the Radiation Oncology Center, Mallinckrodt Institute of Radiology. The 10-year overall and disease-free survival was 77.8 and 76.0%. The expected survival for an age-, sex-, and race-matched population was not significantly greater at 87.2%. The 10-year disease-free survival for the distinct tumor types was 100% for Cushing's disease, 82.3% for patients with amenorrhea/galactorrhea, 79.6% for non-functioning adenomas, 69.0% for acromegaly, and 66.7% for Nelson's syndrome. Prognostic variables analyzed were age, race, sex, tumor type, tumor extent, visual field defects at diagnosis, and volume irradiated. Only the presence of visual field defects at diagnosis conferred a poor prognosis (p < 0.001). There was a tendency toward superior tumor control with radiation doses greater than 4500 cGy (p = 0.15). The median time to progression of disease was 4.2 years, with the last failure occurring at 12 years following the completion of radiotherapy. Severe complications were apparent in 5 patients (7.1%), including one death from central nervous system radionecrosis.
AB - Prognostic factors and results of therapy were analyzed in a retrospective review of 70 patients with pituitary adenomas treated with radiotherapy alone from January 1954 through December 1982 at the Radiation Oncology Center, Mallinckrodt Institute of Radiology. The 10-year overall and disease-free survival was 77.8 and 76.0%. The expected survival for an age-, sex-, and race-matched population was not significantly greater at 87.2%. The 10-year disease-free survival for the distinct tumor types was 100% for Cushing's disease, 82.3% for patients with amenorrhea/galactorrhea, 79.6% for non-functioning adenomas, 69.0% for acromegaly, and 66.7% for Nelson's syndrome. Prognostic variables analyzed were age, race, sex, tumor type, tumor extent, visual field defects at diagnosis, and volume irradiated. Only the presence of visual field defects at diagnosis conferred a poor prognosis (p < 0.001). There was a tendency toward superior tumor control with radiation doses greater than 4500 cGy (p = 0.15). The median time to progression of disease was 4.2 years, with the last failure occurring at 12 years following the completion of radiotherapy. Severe complications were apparent in 5 patients (7.1%), including one death from central nervous system radionecrosis.
KW - Acromegaly
KW - Chromophobe adenomas
KW - Cushing's disease
KW - Irradiation
KW - Nelson's syndrome
KW - Pituitary
KW - Prolactinomas
UR - http://www.scopus.com/inward/record.url?scp=0023792232&partnerID=8YFLogxK
U2 - 10.1016/0360-3016(88)90191-5
DO - 10.1016/0360-3016(88)90191-5
M3 - Article
C2 - 3182342
AN - SCOPUS:0023792232
SN - 0360-3016
VL - 15
SP - 1103
EP - 1110
JO - International journal of radiation oncology, biology, physics
JF - International journal of radiation oncology, biology, physics
IS - 5
ER -