GAMMA KNIFE RADIOSURGERY FOR FUNCTIONING PITUITARY ADENOMAS

Abstract

Pituitary adenomas are one of the most common intracranial lesions. With a reported annual incidence of 20% they constitute 10-20% of all primary brain tumors. Pituitary adenomas are generally classified as either “functioning” or “non-functioning,” with the former (secreting adenomas) representing about 70% of all pituitary tumors. The most frequent functioning pituitary adenomas are prolactinomas, growth hormone hormones secreting adenomas and Cushing’s disease. The management of functioning pituitary adenomas is sophisticated involving a spectrum of therapeutic options amongst which are: medical therapy, surgical resection, and stereotactic radiosurgery (SRS), or different combinations of these options. Although surgery is the first line treatment for functioning pituitary adenomas with the exception of prolactinomas, Radiosurgery has been used as an adjuvant therapy since surgery does not always culminate to complete/permanent remission. Over the last decade the indications of radiosurgery have been expanded to engage it as a first line treatment in a selected number of patients not amenable to surgery. The objectives of our study were to evaluate the effectivenessGamma Knife Radiosurgery (GK SRS) in terms of tumor volume control and biochemical remission and explore their prognostic factors. We further assessed the effect of tumor and biochemical control on vision. Finally, we assessed the morbidity association with GK SRS for functioning pituitary adenomas. A total of 129 patients with a minimum follow up duration of 24 months were included in our study amongst which were 58 patients with prolactinomas, 16 cases with Cushing’s disease and 55 cases with growth hormone secreting adenomas.