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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Repeat gamma knife radiosurgery for recurrent pituitary adenomas
Marco Losa1, Luigi Albano2,3, Elena Prandino2
1Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. losa.marco@hsr.it.
Journal of Endocrinological Investigation
|March 20, 2025
Summary
Repeat Gamma Knife radiosurgery (GKRS) effectively controls pituitary adenoma regrowth in most patients. This repeat GKRS treatment is a safe therapeutic option for recurrent pituitary adenomas when initial treatment fails.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Endocrinology
Background:
- Pituitary adenoma recurrence after Gamma Knife radiosurgery (GKRS) affects approximately 10% of patients.
- Evaluating repeat GKRS is crucial for managing tumor regrowth after initial treatment.
Purpose of the Study:
- To assess the efficacy and safety of repeat Gamma Knife radiosurgery (GKRS) for pituitary adenoma recurrence.
- To identify factors associated with tumor control and adverse events after repeat GKRS.
Main Methods:
- Retrospective analysis of 38 patients undergoing repeat GKRS for pituitary adenoma from 1994-2023.
- Primary endpoint: tumor growth control; Secondary endpoints: neurological, visual, and endocrine function.
- Median follow-up of 71.5 months.
Main Results:
- Tumor progression-free survival at 5 and 10 years was 75.2% and 61.7%, respectively.
- Factors predicting recurrence included hormone-secreting adenoma, prior surgery, and shorter interval between GKRS treatments.
- Repeat GKRS showed a favorable safety profile with minimal serious side effects.
Conclusions:
- Repeat GKRS is effective in controlling pituitary adenoma regrowth.
- It represents a viable therapeutic option for patients with recurrent tumors after initial GKRS.
- The procedure is generally safe, with manageable endocrine deficits.
