Abstract
In this paper, the role of conventional radiotherapy and radiosurgery in the management of pituitary tumors is reviewed. After a short summary of the mechanism of action of irradiation therapy and the types of different irradiation techniques, the therapeutic effects and side effects are analyzed in patients with different types of pituitary tumors, including our own experience with conventional radiotherapy and radiosurgery in patients with acromegaly. Conventional fractionated radiotherapy has long been used to control growth and/or hormonal secretion of residual or recurrent pituitary tumors. However, patient selection for conventional radiotherapy still remains a controversial issue, because a number of potentially significant side effects, including hypopituitarism and other complications, have been described. Stereotactic radiotherapy/radiosurgery methods have several potential advantages over conventional radiotherapy, including their use in patients with residual or recurrent pituitary tumors who had previously been treated by conventional radiotherapy, but long-term follow-up data with these relatively new techniques are still limited.
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Freda, P. U. and Wardlaw, S. L. (1999). J. Clin. Endocrinol. Metab. 84, 3859–3866.
Szeifert, G. and Nyáry, I. (1998). Orv. Hetil. 139, 2627–2632.
Tarján, I. (1991). In: Fundamentals of biophysics. Rontó, Gy. and Tarján, I. (eds.). Medicina: Budapest, pp. 67–141.
Kuhn, E. (1995). In: Fundamentals of radiology. Horváth, F. (ed.). Medicina: Budapest, pp. 315–350.
Marekova, M., Cap, J., Vokurkova, D., Vavrova, J., and Cerman, J. (2003). Endocr. J. 50, 621–628.
Harris, A. G. (1991). In: Acromegaly. Harris, A. G. (ed.). Sandoz Pharma Ltd.: Basle, pp. 61–65.
Marcou, Y. and Plowman, P. N. (2000). Trends Endocrinol. Metab. 11, 132–137.
Plowman, P. N. (1999). Clin. Endocrinol. 51, 265–271.
Varady, P., Dheerendra, P., Nyary, I., Vajda, J., and Ladislau, S. (1999). Orv. Hetil. 140, 331–345.
Jackson, I. M. and Noren, G. (1999). Endocrinol. Metab. Clin. North Am. 28, 133–142.
Plowman, P. N. (2000). J. R. Coll. Physicians Lond. 34, 273–281.
Jackson, I. M. and Noren, G. (1999). Baillieres Best Pract. Res. Clin. Endocrinol. Metab. 13, 461–469.
Brada, M., Ajithkumar, T. V., and Minniti, G. (2004). Clin. Endocrinol. 61, 531–543.
Bradley, K., Adams, C., Potter, C., Wheeler, D., Anslow, P., and Burke, C. (1994). Clin. Endocrinol. 41, 655–659.
Boelaert, K. and Gittoes, N. J. (2001). Eur. J. Endocrinol. 144, 569–575.
Alameda, C., Lucas, T., Pineda, E., et al. (2005). J. Endocrinol. Invest. 28, 18–22.
Sasaki, R., Murakami, M., Okamoto, Y., et al. (2000). Int. J. Radiat. Oncol. Biol. Phys. 47, 1337–1345.
Milker-Zabel, S., Debus, J., Thilmann, C., Schlegel, W., and Wannenmacher, M. (2001). Int. J. Radiat. Oncol. Biol. Phys. 50, 1279–1286.
Pollock, B. E., Nippoldt, T. B., Stafford, S. L., Foote, R. L., and Abboud, C. F. (2002). J. Neurosurg. 97, 525–530.
Landolt, A. M. and Lomax, N. (2000). J. Neurosurg. 93, 14s-18s.
Petrovich, Z., Yu, C., Giannotta, S. L., Zee, C. S., and Apuzzo, M. L. (2003). Neurosurgery 53, 51–59; discussion 59–61.
Becker, G., Kocher, M., Kortmann, R. D., et al. (2002). Strahlenther. Onkol. 178, 173–186.
Goffman, T. E., Dewan, R., Arakaki, R., Gorden, P., Oldfield, E. H., and Glatstein, E. (1992). Cancer 69, 271–275.
Barrande, G., Pittino-Lungo, M., Coste, J., et al. (2000). J. Clin. Endocrinol. Metab. 85, 3779–3785.
Shin, M. (2002). Biomed. Pharmacother. 56, 178s-181s.
Ikeda, H., Jokura, H., and Yoshimoto, T. (2001). J. Neurosurg. 95, 285–291.
Morange-Ramos, I., Regis, J., Dufour, H., et al. (1998). Acta Neurochir. 140, 437–443.
Thorén, M., Rähn, T., Guo, W. Y., and Werner, S. (1991). Neurosurgery 29, 663–668.
Witt, T. C., Kondziolka, D., Flickinger, J. C., and Lunsford, L. D. (1998). In: Gamma knife brain surgery. Prog. Neuro. Surg. Lunsford, L. D., Kondziolka, D., and Flickinger, J. C. (eds.). Karger: Basel, pp. 114–127.
Howlett, T. A., Plowman, P. N., Wass, J. R., Rees, L. H., Jones, A. E., and Besser, G. M. (1989). Clin. Endocrinol. 31, 309–323.
Brucker-Davis, F., Oldfield, E. H., Skarulis, M. C., Doppman, J. L., and Weintraub, B. D. (1999). J. Clin. Endocrinol. Metab. 84, 476–486.
Buchfelder, M. (2002). The Endocrinologist 12, 117–125.
Beck-Peccoz, P., Brucker-Davis, F., Persani, L., Smallridge, R. C., and Weintraub, B. D. (1996). Endocr. Rev. 17, 610–638.
Socin, H. V., Chanson, P., Delemer, B., et al. (2003). Eur. J. Endocrinol. 148, 433–442.
Smallridge, R. C. (2001). Curr. Opin. Endocrinol. Diabetes 8, 253–258.
Pollock, B. E. and Carpenter, P. C. (2003). Neurosurgery 53, 1086–1091; discussion 1091–1094.
Breen, P., Flickinger, J. C., Kondziolka, D., and Martinez, A. J. (1998). J. Neurosurg. 89, 933–938.
Losa, M., Valle, M., Mortini, P., et al. (2004). J. Neurosurg. 100, 438–444.
Sheehan, J. P., Kondziolka, D., Flickinger, J., and Lunsford, L. D. (2002), J. Neurosurg. 97, 408s-414s.
Feigl, G. C., Bonelli, C. M., Berghold, A., and Mokry, M. (2002), J. Neurosurg. 97, 415s-421s.
Lim, Y. L., Leem, W., Kim, T. S., Rhee, B. A., and Kim, G. K. (1998). Stereotact. Funct. Neurosurg. 70, 95s-109s.
Landolt, A. M., Haller, D., Lomax, N., et al. (1998). J. Neurosurg. 88, 1002–1008.
Shin, M., Kurita, H., Sasaki, T., et al. (2000). J. Neurosurg. 93, 2s-5s.
Levy, R.P., Fabricant, J. I., Frankel, K. A., et al. (1991), Stereotact. Funct. Neurosurg. 57, 22–35.
Niranjan, A., Szeifert, Gy. T., Kondziolka, D., Flickinger, J. C., Maitz, A. H., and Lunsford, L. D. (2002). In: Radiosurgery. Kondziolka, D. (ed.). Karger: Basel, pp. 93–101.
Flickinger, J. C., Nelson, D. B., Martinez, A. J., Deutsch, M., and Taylor, F. (1989). Cancer 63, 2409–2414.
Minniti, G., Traish, D., Ashley, S., Gonsalves, A., and Brada, M. (2005). J. Clin. Endocrinol. Metab. 90, 800–804.
Erfurth, E. M., Bulow, B., Mikoczy, Z., Svahn-Tapper, G., and Hagmar, L. (2001). Clin. Endocrinol. 55, 613–616.
Jones, A. (1991). Clin. Endocrinol. 35, 379–397.
Flickinger, J. C., Lunsford, L. D., Wu, A., Maitz, A. H., and Kalend, A. (1990). Int. J. Radiat. Oncol. Biol. Phys. 18, 1495–1501.
Flickinger, J. C., Deutsch, M., and Lunsford, L. D. (1989). Int. J. Radiat. Oncol. Biol. Phys. 17, 171–175.
Flickinger, J. C., Maitz, A. H., Kalend, A., Lunsford, L. D., and Wu, A. (1990). Int. J. Radiat. Oncol. Biol. Phys. 19, 783–789.
Holdaway, I. M. (2004). Horm. Res. 62, 79s-92s.
Powell, J. S., Wardlaw, S. L., Post, K. D., and Freda, P. U. (2000). J. Clin. Endocrinol. Metab. 85, 2068–2071.
Swords, F. M., Allan, C. A., Plowman, P. N., et al. (2003). J. Clin. Endocrinol. Metab. 88, 5334–5340.
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Mondok, Á., Szeifert, G.T., Mayer, Á. et al. Treatment of pituitary tumors. Endocr 28, 77–85 (2005). https://doi.org/10.1385/ENDO:28:1:077
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DOI: https://doi.org/10.1385/ENDO:28:1:077