Maciel R, Ramírez V, González A, Valdez E, Lucino-Castillo J, Prajsnar A

Language: Spanish
References: 12
Page: 573-580
PDF size: 95.74 Kb.

ABSTRACT

Introduction: There is scientific evidence of reduction in hormonal levels, clinical improvement, and tumor volume reduction in pituitary adenomas treated with radiosurgery (SRS) or stereotactic conformational radiotherapy (SCRT).The purpose of this work is to show our preliminary results. Objective: To analyze retrospectively and prospectively, the clinical, endocrinological and radiological evolution of patients with pituitary adenomas treated with stereotactic radiosurgery (SRS) or stereotactic conformational radiotherapy (SCRT). Methods: Between 2000 and 2005, we studied all the patients at the CMN 20 of November ISSSTE with the diagnosis of pituitary adenomas treated with SRS or SCRT; we included only 14 patients. The average age was 41.5 years, 9 (64.2%) females and 5 (36.8%) males. We considered if the tumors were non-functional or functional, and which hormone they produce, its extrasellar extension, and their main symptoms, as well as the side effects of the treatment. All the previous treatments were considered, like surgery or previous radiotherapy. Results: The tumors were: 2 (13%) non functional, and 12 (87%) functional, 9 (60%) were producers of GH, 3 (20%) of ACTH, and 1 (7%) prolactine and GH. The dose of treatment was from 16 to 20 Gy for SRS, and 48 to 50 Gy in 25 to 28 sessions for SCRT. The average decrease in GH secretion was 44.88%, for ACTH 52.8%, serum cortisol 31.3% and urinary cortisol 78.6%. Conclusions: We considered that SRS and SCRT are acceptable treatments for pituitary adenomas as single treatment or in conjunction with surgery, in cases where surgery or medical treatment have not been able to reduce hormone levels. We should increase the follow-up time and the number of patients in order to obtein more reliable results.

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