Stereotactic radiosurgery for pituitary metastases

被引:41
|
作者
Kano, Hideyuki [3 ]
Niranjan, Ajay [3 ]
Kondziolka, Douglas [3 ]
Flickinger, John C. [2 ]
Lunsford, L. Dade [1 ,3 ]
机构
[1] Univ Pittsburgh, UPMC Presbyterian, Dept Neurol Surg, Sch Med, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, Sch Med, Dept Radiat Oncol, Pittsburgh, PA 15213 USA
[3] Univ Pittsburgh, Sch Med, Ctr Image Guided Neurosurg, Pittsburgh, PA 15213 USA
来源
SURGICAL NEUROLOGY | 2009年 / 72卷 / 03期
关键词
Stereotactic radiosurgery; Gamma Knife; Pituitary metastases; Diabetes insipidus; Hormone replacement; DIABETES-INSIPIDUS; GLAND; TUMORS; CARCINOMA; ADENOMA; CANCER; FEATURES;
D O I
10.1016/j.surneu.2008.06.003
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: We evaluated the role of Gamma Knife SRS in the multidisciplinary management of metastatic cancer to the pituitary gland. Methods: We retrospectively reviewed records of 18 consecutive pituitary metastasis patients who underwent Gamma Knife SRS during a 21-year experience. The median patient age was 57.6 years (range, 27.0-81.1 years). There were 5 patients who had initial surgical resection of their pituitary metastasis, 5 who had fractionated radiation, and 7 who had CT before SRS. The median radiosurgery target volume was 3.5 mL (range, 0.2-18.0 mL), and the median marginal dose was 13.0 Gy (range, 9-18 Gy). Results: The overall survival after SRS at 3, 6, and 12 months, respectively, was 66%, 36%, and 18%. The median survival after SRS was 5.2 months. The progression-free survival after SRS was 100% and 66.7% at 6 and 12 months, respectively. The only factor associated with an improved overall survival was younger age at presentation. Diabetes insipidus improved in 3 (42.9%) of 7 patients. Neurological symptoms or signs improved in 4 (50.0%) of 8 patients. Three (16.7%) patients developed new neurological deficits due to tumor progression despite SRS. Conclusion: Development of a pituitary metastasis is an ominous finding in the context of systemic cancer. Stereotactic radiosurgery is an effective palliative approach for most patients with pituitary metastasis. (C) 2009 Elsevier Inc. All rights reserved.
引用
收藏
页码:248 / 255
页数:8
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