Stereotactic Radiosurgery/Radiotherapy for Pituitary Adenomas : A Review of Recent Literature
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概要
- 論文の詳細を見る
The recent clinical results are reviewed of stereotactic radiosurgery/radiotherapy for the treatment of pituitary adenomas. The outcomes of pituitary adenomas treated by stereotactic radiosurgery/radiotherapy with gamma knife, CyberKnife, or linear accelerator (LINAC) radiosurgery were evaluated from articles published after 2004. Each study was evaluated for the number of patients, radiosurgical parameter (marginal dose), length of follow up, tumor growth control, rate of hormonal normalization in secretary adenomas, and adverse events. After gamma knife radiosurgery, the tumor reduction rates varied from 42.3% to 89% in non-secreting adenomas. However, the tumor control rates in non-secreting adenomas were more than 90% in most studies. In growth hormone-secreting adenomas, the rates of insulin-like growth factor-1 normalization ranged from 36.9% to 82%. In adrenocorticotropin-secreting adenomas, the rates for 24-hour urine free cortisol normalization ranged from 27.9% to 54%. In prolactin-secreting adenomas, the prolactin normalization ranged from 17.4% to 50%. New hormonal deficits ranged from 0% to 34%. New visual deficits were relatively low. The number of patients treated with CyberKnife and LINAC radiosurgery/radiotherapy was small and follow-up periods were relatively short compared to those with gamma knife treatment, but the clinical outcomes after these therapies were similar to those after gamma knife therapy. Image-guided stereotactic radiosurgery/radiotherapy with the gamma knife, CyberKnife, or LINAC system is effective and safe against pituitary adenomas. Careful long-term follow up of the patients is necessary because of long-term anti-tumor effects and delayed adverse events.
- 社団法人 日本脳神経外科学会の論文
- 2010-09-15
著者
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SAITO Ken-ichi
Department of Kampo Medicinal Science, Hokkaido College of Pharmacy
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FUJII Masami
Department of Neurosurgery, Yamaguchi University School of Medicine
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Sakamoto Kenichi
Department Of Neurosurgery Clinical Neuroscience Yamaguchi University School Of Medicine
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Fujii Masami
Department Of Neurosurgery Clinical Neuroscience Yamaguchi University School Of Medicine
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Kato Shouichi
Department Of Neurosurgery Yamaguchi University School Of Medicine
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Kato Shoichi
Department Of Neurosurgery Yamaguchi University School Of Medicine
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Kajiwara Koji
Department Of Neurosurgery Clinical Neuroscience Yamaguchi University School Of Medicine
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Nomura Sadahiro
Department Of Neurosurgery Institute Of Neuroscience St. Mary's Hospital
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Kajiwara Koji
Department Of Electrical Engineering And Information System School Of Engineering The University Of
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Kashiwagi Shiro
Department Of Neurosurgery Yamaguchi University School Of Medicine
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Suzuki Michiyasu
Departments Of Neurosurgery Yamaguchi University School Of Medicine
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Yoshikawa Koichi
Department Of Neurosurgery Yamaguchi University School Of Medicine
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Fujii Masami
Departments Of Neurosurgery Yamaguchi University School Of Medicine
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IDEGUCHI Makoto
Department of Neurosurgery, Yamaguchi University School of Medicine
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Suzuki Michiyasu
Department Of Neurosurgery Clinical Neuroscience Yamaguchi University School Of Medicine
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Ideguchi Makoto
Department Of Neurosurgery Yamaguchi University School Of Medicine
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Ideguchi Makoto
Department Of Chemical Engineering Kyushu University
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Nomura Sadahiro
Department Of Neurosurgery Clinical Neuroscience Higher Biointegration Yamaguchi University Graduate School Of Medicine
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Suzuki Michiyasu
Department Of Neurosurgery Clinical Neuroscience Higher Biointegration Yamaguchi University Graduate School Of Medicine
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Suzuki Michiyasu
Department of Neurosurgery and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Japan
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