|
KMID : 0942820110100020097
|
|
Journal of Korean Brain Tumor Society
2011 Volume.10 No. 2 p.97 ~ p.102
|
|
|
Outcome of GKRS for Growth Hormone-Secreting Pituitary Adenoma
|
|
Kim Ji-Hoon
Kwon Do-Hoon
Kim Chang-Jin
Kim Jeong-Hoon
|
|
|
Abstract
|
|
|
Purpose: To evaluate the safety and efficacy of gamma knife radiosurgery (GKRS) in patients with growth hormone-secreting pituitary adenoma (GHPA) and factors related to good outcomes.
Methods: We retrospectively evaluated results of 20 patients with GHPA who underwent GKRS between January 1991 and December 2008 and were followed-up for at least 10 months. Successful endocrine outcome was defined as a random human growth hormone (hGH) concentration＜2 ng/mL. Tumor volume was also assessed. At least 10 months (mean 67.8) of endocrine and magnetic resonance imaging (MRI) follow-up was available in all patients who received GKRS during the study period. The correlations between endocrine remission and marginal dose, tumor volume, and pre-GKRS hGH concentration were analyzed.
Results: The 20 patients consisted of 10 men and 10 women, of mean age 42.6 years (range 21 to 66 years). Of these 20 patients, 17 received GKRS as adjuvant treatment and 3 as primary therapy. The mean marginal dose of GKRS was 28 Gy (range 12-35 Gy), with 12 Gy administered to tumor sites adjacent to the optic nerve, and mean tumor volume was 1,818 mm3 (range 150-4,900 mm3). Mean endocrine follow up was 67.8 months (range 19-155 months) and mean MRI follow up was 52.7 months (range 10-102 months). hGH concentrations decreased in 16 patients (80%), but only 6 (30%) attained normal level (＜2 ng/mL) at a mean 19.0 months (range 10-44 months). Decreased tumor volume was observed in 17 patients (85%), in whom hGH declined at a mean 10.1 months (range 2-16 months), whereas tumor volume declined at a mean 13.9 months (range 6-36 months). Endocrine remission was not correlated with marginal dose or tumor volume. Normal hGH concentrations were achieved by 6 of 12 (50.0%) patients with pre-GKRS hGH＜20 ng/mL, but by 0 of 8 with pre-GKRS hGH＞20 ng/mL. Five of 18 (27.8%) patients had new onset panhypopituitarism, but none showed decreased visual acuity.
Conclusion: GKRS is a safe and effective treatment method in selected patients with GHPA. Pre-GKRS hGH level was the best predictor of good outcomes following GKRS for GHPA.
|
|
|
KEYWORD
|
|
|
Growth hormone-secreting pituitary adenoma, Endocrine remission, Tumor volume, Gamma knife radio surgery
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|