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Stereotactic radiosurgery for pituitary and cavernous sinus metastases
Yen-Yu Lin1,2, Hsiu-Mei Wu2,3, Huai-Che Yang1,2
1Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Journal of Neuro-Oncology
|January 8, 2023
Summary
Stereotactic radiosurgery (SRS) is a safe and effective treatment for rare pituitary and cavernous sinus metastases. This focused radiation therapy offers good tumor control and survival rates for patients with these challenging conditions.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Metastases to the pituitary gland and cavernous sinus are rare but increasingly reported due to advanced neuroimaging.
- Stereotactic radiosurgery (SRS) enables precise radiation delivery to minimize side effects.
Purpose of the Study:
- To assess the efficacy and safety of SRS for treating pituitary and cavernous sinus metastases.
- To compare outcomes between patients with pituitary versus cavernous sinus involvement.
Main Methods:
- Analysis of 23 patients treated with SRS between 1996 and 2021.
- Categorization into pituitary (n=11) and cavernous sinus (n=12) metastasis groups.
- Kaplan-Meier analysis to compare overall survival and local/distal tumor control rates.
Main Results:
- Overall survival rates at 1, 2, and 3 years were 72.9%, 51.8%, and 45.3%, respectively.
- Local tumor control rates at 1, 2, and 3 years were 82.3%, 82.3%, and 65.9%, respectively.
- Common presentations included visual deficit/hypopituitarism (pituitary) and cranial nerve deficit (cavernous sinus).
Conclusions:
- SRS is a safe and effective treatment for pituitary and cavernous sinus metastases.
- Gamma Knife radiosurgery (GKRS) is a minimally stressful procedure, supporting further anti-cancer therapy.
- Post-treatment complications are unlikely to be a significant issue given the limited survival duration in metastatic cases.
