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60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

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Stereotactic LINAC-radiosurgery for non-secreting pituitary adenomas: long-term results

Meeting Abstract

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  • M. Runge - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • J. Voges - Klinik für Stereotaktische Neurochirurgie, Otto-von Guericke Universität, Magdeburg
  • H. Treuer - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • M. Ruge - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • M. Kocher - Klinik und Poliklinik für Strahlentherapie, Klinikum der Universität zu Köln
  • M. Maarouf - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln
  • V. Sturm - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMI.07-09

doi: 10.3205/09dgnc220, urn:nbn:de:0183-09dgnc2200

Published: May 20, 2009

© 2009 Runge et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: During the last years stereotactic radiosurgery has become an increasingly utilised therapeutic option for microsurgically inaccessible remnants or recurrence of pituitary adenomas. We present long-term results of patients treated with stereotactic linear accelerator based radiosurgery (LINAC-RS) for non-secreting pituitary adenomas (NSAs).

Methods: Between 1992 and August 2008 65 NSAs were treated with LINAC-RS. Patient treatment and follow-up were conducted according to a prospective protocol. The indication for LINAC-RS was progressive recurrent tumour in 35 cases (58%) and tumour remnant after (repeated) surgery in 23 (38%). 2 patients (3%) declined surgery and were treated with primary radiosurgery. The clinical and endocrinological courses as well as consecutive MRI-scans of 60 patients with a minimum follow-up of 12 months were evaluated retrospectively.

Results: The mean tumour volume was 5.2cm³ (standard deviation 4.2cm³, range 0.3–17.3cm³), and the mean therapeutic dose 13Gy (standard deviation 1.7Gy). A mean maximum dose of 28.8Gy (standard deviation 10.2Gy) was applied. Mean follow-up of the 60 patients was 91 months (range 15–189mth). One patient died of unknown reason 3 years after treatment. Two patients (3.3%) developed neurological deficits. In 38 of 43 patients (88%) LINAC-RS caused no adverse effects concerning pituitary function. 98% of the cases showed local tumour control, and in 41% the tumours exhibited partial remission following LINAC-RS.

Conclusions: LINAC-RS is a minimally invasive, safe and effective treatment for recurrent NSA or microsurgically inaccessible tumour remnants. LINAC-RS yielded a high rate of local tumour control with a small number of radiation-induced side effects.