Fractionated Stereotactic Radiotherapy for Pituitary Adenomas

Abstract

Purpose or Objective Retrospective review of patients with pituitary adenomas who have been treated by fractionated stereotactic radiotherapy at our department. Material and Methods Between April of 2005 and December of 2014 we have treated 181 patients. 52% of cases were functional adenomas and, 48% non-functional adneomas. 40% of patients were men and 60% women. The median age was 44 years. The main indication for radiotherapy was postoperative residual tumor in 47.5%, with closeness of the optical nerves or chiasm in 75.2% of cases. The schedule of treatment was 50Gy at 2Gy per fraction, in all patients. Results The median of follow up was 50 months. At the end of the study 53.5% of the patients presented disease stabilization, 39,6% decrease of the tumor size and 5,9% complete response. Only 1% of the patients had disease progression. Related to clinical situation 63,2% of the patients related the same symptom as before the treatment, and 30,5% had improvement of their quality of live. Only 6,3% of the patients had worsening of their symptoms. Between cases with functioning adenomas 24,5% of patients reduced their endocrine treatment, only 18,9% of patients increased their treatment, the remainder had the same treatment. No acute toxicity was reported in 66% of the patients. The most frequent one was headache (21%), mainly grade 1 (84,8%), no grade 3 or higher toxicity was recorded. In the 89,1% not late toxicity was reported. Conclusion Fractionated Stereotactic Radiotherapy is a modality of treatment good tolerated and with excellent local control.