Volume : VIII, Issue : V, May - 2018

A retrospective study to analyze the role of Stereotactic Radio Surgery in management of Pituitary Adenoma.

Dr Shashivadhanan

Abstract :

Introduction: About two–thirds of pituitary adenomas may secrete excess hormones. While radiation therapy provides excellent radiographic local control for functioning adenomas, the actuarial rate of biochemical normalization is far less predictable and heavily depends on histology .The goal of pituitary adenoma radiosurgery is to permanently control tumor growth, maintain pituitary function, normalize hormonal secretion in the case of functional adenomas, and preserve neurological function, especially vision.The major role of pituitary adenoma stereotactic radiosurgery(SRS) is as an adjuvant to surgical resection, although it has a primary role for selected cases that are higher medical risk for general anesthesia or microsurgery, for patients with cavernous sinus tumor involvement, and for patients who consciously choose not to undergo microsurgery. Treatment of pituitary hormonal hyper– and hypofunction is necessary to optimize overall quality of life and reduce comorbidities and mortality. These patients require life–long observation to ensure optimal hormonal management and monitor for tumor recurrence.While surgical excision offers rapid biochemical remission,SRS has a long latency period. It may extend upto 2 years. Amongst all functional adenomas,Prolactinomas have the longest time for remission. As on date there are no clear guidelines for SRS with respect tofunctional pituitary tumors. There are very few outcome predictors post SRS.In the backdrop of no clear cut guidelines this retrospective study was undertaken and attempt has been made to come up with management guidelines for functional pituitary tumors.

Materials &Methods: This retrospective study was conducted in a tertiary care institute with facility of Gamma Knife Radiosurgery .All pituitary tumors treated with SRS were included in this study from 2007 to 2016.All cases were followed up for a period of 2 years.Almost all cases were subjected to SRS following surgery based on radiological evidence of mass effect. Functional Pituitary tumors(FPA) were given a dose of 20 Gy while the Non Functional Pituitary Tumors(NFPA) were offered dose of 15 Gy. They were monitored for endocrinological improvement and visual field defects.

Observation: Our study has shown that combined treatment is the ideal treatment of choice as it provides control of tumor growth and also endocrinological control in 84% of tumors.Main complications include hypopituitarism and visual deterioration.Largetumr is a potential risk factor for recurrence.

Conclusion: This study prove that SRS has a definite role in management of Functional pituitary tumors.

Keywords :

Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Dr Shashivadhanan, A retrospective study to analyze the role of Stereotactic Radio Surgery in management of Pituitary Adenoma., INDIAN JOURNAL OF APPLIED RESEARCH : Volume-8 | Issue-5 | May-2018

Number of Downloads : 344

References :