The Efficacy of Conventional Radiation Therapy in The Management of Pituitary Adenoma

Authors

  • Putipun Puataweepong Department of Radiology, Ramathibodi Hospital
  • Mantana Dhanachai Department of Radiology, Ramathibodi Hospital
  • Puangtong Kraiphibul Department of Radiology, Ramathibodi Hospital
  • Veerasak Theerapancharoen Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
  • Lucksana Pochanugool Department of Radiology, Ramathibodi Hospital
  • Somjai Dangprasert Department of Radiology, Ramathibodi Hospital
  • Jiraporn Laothamatas Department of Radiology, Ramathibodi Hospital
  • Suchart Phudhichareonrat Department of Pathology, Prasart hospital, Bangkok

Keywords:

Pituitary adenoma, Radiotherapy

Abstract

Objective: To evaluate the efficacy and late complication of conventional external beam radiation therapy (EBRT) in the management of patients with pituitary adenoma.

Materials and Methods: The study involved a retrospective review of 22 patients with pituitary adenoma treated at the Radiotherapy Unit in Ramathibodi hospital during September 1990 to December 20000. Of these 22 patients, 21 had received postoperative radiotherapy, and 1 had received radiotherapy alone. The median total dose was 54 (46-60) Gy. Affer treatment the patient were evaluated periodically by physical examination, imaging, and endocrine testing. The local control rate, overall survival and side effects were analyzed.

Result: Median follow-up time was 4.6 (0.6-9.7) years. Tumor control was achieved in 21 patients (95%). In 1 patient, recurrence of disease was diagnosed 6 years after radiotherapy and was salvaged by surgery. There were 2 deaths, 1 from CA head of pancreas and another from CVA. The 10 year overall survival rate was 91%. Hypopituitarism requiring hormonal replacement was observed in 55% of the patients and all except one had hypopituitarism since prior to radiation. In 1 patient receiving radiation alone, hypopituitarism was developed and hormonal replacement was started at 6 months after radiation. There was no brain necrosis, optic neuropathy or radiation induce secondary tumor in this study.

Conclusion: Conventional external radiotherapy was effective in long-term control of the pituitary adenoma and produced acceptably low complication rates.

References

Annegers JW, Coulam CB, Abboud CF, et al. Pitui- tary adenoma in Olmsted County, Minnesota, 1965- 1977. Mayo Clin Proc 1978; 53: 641-643.

Faglia G. Epidemiology and pathogenesis of pituitary adenoma. Acta Endocrinol 1993; 129(supple): 1-5.

Annual report 2001: Ramathibodi cancer registry.

Comtois R, Beauregare H, Somma M, Serri O, Arisjilwan N, Hardy J. The clinical and endocrine outcome to transphenoidal microsurgery of non- secreting pituitary adenomas. Cancer 1991; 68: 860-886.

Chun M, Masko GB, Hetelekidis S. Radiotherapy in the treatment of pituitary adenomas. Int I Radiat Oncol Biol Phys 1988; 15: 305-309.

Erlichman C, Meakin JW, Simpson WI. Review of 154 patients with nonfunctioning pituitary tumors. Int J Radiat Oncol Biol Phys 1979; 1981-1986.

Flickinger JC, Nelson PB, Martinwz AJ, Deutsch M, Taylor F. Radiotherapy of nonfunctional adenomas of the pituitary gland. Result with long-term follow- up. Cancer 1989; 63: 2409-2414.

Grigsby PW, Simpson JR, Emami BN, Finebeberg BB, Schwartz HG. Prognostic factors and results of sur- gery and postoperative irradiation in the management of pituitary adenomas. Int J Radiat Oncol Biol Phys 1989; 16: 1411-1417.

McCollogh WM, Marcus RB, Rhoton AL, Ballinger WL, Million RR. Long-term follow up of radiotherapy for pituitary adenoma. The absence of late recurrence after 45 Gy. Int J Radiat Oncol Biol Phys 1991; 21: 607-614.

Tran LM, Blount L, Horton D, Sadeghi A, Parker RG. Radiation therapy of pituitary tumors: Results in 95 cases. Am I Clin Oncol 1991; 14:25-29.

Sasaki R, Murakami M, Okamoto Y, et al. The effi- cacy of conventional radiation therapy in the man- agement of pituitary adenoma. Int J Radiat Oncol Biol Phys 2000; 47: 1337-1345.

Tsang RW, Bierley JD, Panzarella T, et al. Radion therapy for pituitary adenoma: Treatment outcome and prognostic factor. Int J Radiat Oncol Biol Phys 1994; 30: 557-565.

Ziechut D, Flebgie M, Adolph A, et al Extemal radio- therapy of pituitary adenomas. Int I Radiat Oncol Biol Phys 1995; 33: 307-314.

Eastman RC, Golden P, Roth J. Convention imadia- tion is an effective treatment for acromegaly. J Clin Endo crinol Metab 1979; 48: 931-940.

Roth J, Gorden P, Brace K. Efficacy of conventional pituitary irradiation in acreomegaly. N Engl I Med 1970; 282:1385-1391.

Lawrence AM, Pinsky SM, Goldfine ID, et al. Conventional radiation therapy in acromegaly. Arch Intern Med 1971; 128:369-377.

Grossman A, Cohen BL, et al. Treatment of prolactinoma with megavoltage radiotherapy. Br Med. J 1984:288; 1105-1109.

Tsagarakis S, Grossman A, Plowman PN, et al. Megavoltage pituitary irradiation in the mangement of prolactionmas. Long-term follow-up. Clin Endo crinol 1991; 34:399-406.

Jennings AS, Liddle GW, Orth DN. Results of treating childhood Cushing's disease with pituitary iradion. N Engl J Med 1977; 297:957-962.

Orth DN, Liddle GW. Result of treatment 108 patients with Cushing's syndrome. N Eng! J Med 1971; 285:243-247.

Snyder PJ, Fowble BF, Schatz NJ, Savino PJ, Gennarelli TA. Hypopituitarism following radiation therapy of pituitary adenoma. Am J Med 1986; 81:457-462.

Shelin GE. Conventional radiotherapy in the treatment of pituitary tumor. In: Tindall GT, Collins WF eds. Clinical management of pituitary adenoma. New York: Raven Press; 1979:287-314.

Grigsby PW, Thomas PR, Simpson JR, Fineberg BB. Long-term results of radiotherapy in the treatment of pituitary adenomas in children and adolescent. Am J Clin Oncol 1988; 15:1103-1110.

Brada M, Burchell L, Ashley S, Traish D. The incidence of cerebrovascular accidents in patients with pituitary adenoma. Int J Radiat Oncol Biol Phys 1999; 45: 693-698.

Hughes, MN, Lamas KJ, Yelland ME, Tripcony LB. Pituitary adenomas: Long term results for radiotherapy alone and post-operative radiotherapy. Int I Radiat Oncol Biol Phys 1993; 27:1035-1043.

Stieber VW, Deguzman A, Shaw EG. Pituitary. In : Perez CA, Brady LW, Halperin EC, Schmidt-ullrich RP. Eds. Principles and practice of radiation oncology. 4"ed. Philadephia: Lippincott-Raven, 2004:839-859.

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Published

2025-08-02

How to Cite

1.
Puataweepong P, Dhanachai M, Kraiphibul P, Theerapancharoen V, Pochanugool L, Dangprasert S, Laothamatas J, Phudhichareonrat S. The Efficacy of Conventional Radiation Therapy in The Management of Pituitary Adenoma. J Thai Assn of Radiat Oncol [internet]. 2025 Aug. 2 [cited 2025 Dec. 26];10(1-3):17-2. available from: https://he01.tci-thaijo.org/index.php/jtaro/article/view/281450

Issue

Vol. 10 No. 1-3 (2004): January - December

Section

Original articles

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บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารมะเร็งวิวัฒน์ สมาคมรังสีรักษาและมะเร็งวิทยาแห่งประเทศไทย

ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับสมาคมรังสีรักษาและมะเร็งวิทยาแห่งประเทศไทย และบุคคลากรท่านอื่น ๆ ใน สมาคมฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใดๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว