Author/Authors :
Oraee Yazdani، Saeed نويسنده Functional Neurosurgery Research Center,Shahid Beheshti University of Medical Sciences,Tehran,Iran , , Zali، Alireza نويسنده Functional Neurosurgery Research Center,Shahid Beheshti University of Medical Sciences,Tehran,Iran , , Shahrzadi، Sohrab نويسنده Functional Neurosurgery Research Center,Shahid Beheshti University of Medical Sciences,Tehran,Iran , , Alikhani، Mazdak نويسنده Iran Gamma Knife Centre (IGKC),Tehran,Iran , , Tabatabaei، Morteza نويسنده Functional Neurosurgery Research Center,Shahid Beheshti University of Medical Sciences,Tehran,Iran ,
Abstract :
Purpose: To study early treatment outcomes and complications of Gamma Knife Radiosurgery(GKRS) in patients with functional and nonfunctional adenomas.Methods: One hundred patients with a pituitary adenoma who were treated between 2011 and2014 at Iran Gamma Knife Center were studied. The patients were followed up at least 2 years.Radiosurgery was performed using the Leksell Gamma Unit. The median radiation dose was18 Gy for nonfunctional and 24 Gy for functional adenoma. The MRI were compared pre andpost operation for any change in tumor size. Endocrine follow up was used to determine theonset of new hormone deficiency when available or decrease in hormonal level.Results: Our study group comprised 42 men (42%) and 58 women (58%). Ninetythree patientswere treated for recurrent or residual disease after Transsphenoidal surgery or craniotomy and 7patients were treated as primary modality because of extensive involvement of cavernous sinus orhigh risk for surgery. Fortysix patients (46%) had a diagnosis nonfunctional and 54 of patients(54%) had hormonesecreting tumors including growth hormone secreting (23%), prolactinoma(15%) and ACTHsecreting tumor (6%). No mortality was reported. Acute complication wasuncommon and of no clinical significance. Late complication was noted in two patients (2%)and consisted of VI cranial nerve palsy with spontaneous resolution. None of the patientsdeveloped visual loss. Before GKRS, 8 patients had cranial nerve palsy. After the treatment, thepalsy resolved in six (75%) of these patients. Only 9.5% of patients developed hypopituitarismand required replacement therapy. Overall control was 92% (28% decreased in volume and64% were unchanged), 8% experienced an increase in volume size. Normalization of GH andIGF1 for GHsecreting hormone was 48% with overall control of 73%. PRL normalization forprolactinoma was 46% with overall control of 67%. ACTH normalization for ACTHsecretinghormone was 35% with overall control of 70%.Conclusion: It seems that GKRS to be safe and effective method for tumor control and optimalhormonal function.
