Is It Possible To Avoid Hypopituitarism After Irradiation Of Pituitary Adenomas By The Leksell Gamma-knife?

Marek Josef1, Jana Ježková1, Roman Liš?ák1, Vilibald Vladyka1, Václav Hána1, Michal Kršek1, ?ubomíra Bandúrová1, Ladislav Pecen1

11st Medical Faculty, Na Homolce, Prague, Czech Republic

Keywords: hormone dysfunction, gamma knife, pituitary adenoma, radiation injury, complications

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Abstract

     Radiosurgery is one of the treatment options for pituitary adenomas. This approach is typically used when neurosurgical and pharmacological treatment have failed. The most common side effect associated with LGK irradiation is the development of hypopituitarism. We have analyzed factors leading to this unfavourable outcome and suggested that the mean dose of irradiation to pituitary is the most important cause of hypopituitarism.
     The aim of this study was to show that hypopituitarism does not develop if the maximum mean dose to the healthy pituitary is kept under 15 Gy.
     We followed 75 patients with pituitary adenomas treated with LGK irradiation.
     The mean follow-up period was 94.9 months. The patients were divided in two subgroups: the first subgroup consisted of 34 patients irradiated with a mean dose to the pituitary of less than 15 Gy; the second subgroup consisted of 41 patients irradiated with a mean dose to the pituitary of more than 15 Gy.
     Hypopituitarism after LGK irradiation did not develop in 97.1% of patients irradiated with a mean dose to the pituitary of less than 15 Gy. In contrast, hypopituitarism did not develop in only 26.8% patients irradiated with a mean dose to the pituitary of more than 15 Gy.
     This is a retrospective study.
     Keeping the mean radiation dose to the pituitary gland under 15 Gy prevents the development of hypopituitarism following LGK irradiation.
     


Acknowledgements

Project Roles:

M. Josef (), J. Ježková (), R. Liš?ák (), V. Vladyka (), V. Hána (), M. Kršek (), ?. Bandúrová (), L. Pecen ()