Pituitary metastases: current practice in Japan.

Area of Science:

• Neuro-oncology
• Endocrinology
• Radiotherapy

Background:

• Pituitary metastases (PMs) represent a complex clinical challenge.
• Advancements in cancer treatment and neuroimaging necessitate updated understanding of PMs.
• Previous reports may not reflect current clinical presentations and management.

Purpose of the Study:

• To elucidate the current clinical features of pituitary metastases.
• To describe contemporary clinical practice patterns for managing PMs.
• To identify prognostic factors influencing survival in PM patients.

Main Methods:

• Retrospective study involving questionnaires sent to 87 physicians in Japan.
• Data collected on 201 patients treated for PMs between 1995 and 2010.
• Analysis included clinical presentation, neuroimaging, treatment modalities, and survival outcomes.

Main Results:

• Lung cancer was the most frequent primary tumor (36.8%), followed by breast (22.9%) and kidney (7.0%).
• Common symptoms included visual disturbance (30.3%), diabetes insipidus (27.4%), and fatigue (25.4%).
• Stereotactic radiotherapy was utilized in approximately 60% of treated PMs, with a median survival of 12.9 months, longer than previously reported. Younger age, later metastasis, smaller lesion size, and radiation therapy were associated with better prognosis.

Conclusions:

• Current clinical practice for pituitary metastases in Japan heavily relies on stereotactic radiation therapy.
• The median survival time for PM patients has significantly improved compared to historical data.
• Further prospective, population-based studies are essential to confirm these evolving trends in PM clinical features and management.