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Stereotactic radiosurgery for pituitary metastases
Hideyuki Kano1, Ajay Niranjan, Douglas Kondziolka
1Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Surgical Neurology
|September 13, 2008
Summary
Gamma Knife stereotactic radiosurgery (SRS) offers an effective palliative approach for pituitary gland metastases. This treatment improved survival and symptoms in many patients with advanced cancer.
Area of Science:
- Oncology
- Neurosurgery
- Radiation Oncology
Background:
- Pituitary gland metastases are a serious complication of systemic cancer.
- Multidisciplinary management is crucial for these patients.
Purpose of the Study:
- To evaluate the role of Gamma Knife stereotactic radiosurgery (SRS) in managing pituitary gland metastases.
- To assess the efficacy and safety of SRS as a palliative treatment.
Main Methods:
- Retrospective review of 18 patients with pituitary metastases treated with Gamma Knife SRS over 21 years.
- Analysis of patient demographics, prior treatments (surgery, fractionated radiation), and SRS parameters (target volume, marginal dose).
- Evaluation of overall survival, progression-free survival, and symptom improvement post-SRS.
Main Results:
- Overall survival at 3, 6, and 12 months post-SRS was 66%, 36%, and 18%, with a median survival of 5.2 months.
- Progression-free survival was 100% at 6 months and 66.7% at 12 months.
- Improvements observed in diabetes insipidus (42.9%) and neurological symptoms (50.0%); 16.7% developed new deficits.
Conclusions:
- Pituitary metastases indicate a poor prognosis in systemic cancer patients.
- Gamma Knife SRS is an effective palliative treatment option for pituitary metastases, improving survival and symptoms.
- Younger age at presentation was associated with improved overall survival.
