Gamma knife surgery in pituitary microadenomas

Area of Science:

• Neurosurgery
• Endocrinology
• Radiation Oncology

Background:

• Transsphenoidal microsurgery is a standard treatment for pituitary microadenomas but has limitations.
• Early failure and late recurrence rates necessitate alternative therapeutic options.
• Stereotactic radiosurgery, particularly Gamma Knife, is emerging as a viable treatment modality.

Purpose of the Study:

• To evaluate the efficacy of Gamma Knife radiosurgery in managing pituitary microadenomas.
• To assess the hormonal changes following radiosurgery in patients with functioning microadenomas.
• To determine the potential of radiosurgery as an alternative or complementary treatment.

Main Methods:

• Gamma Knife radiosurgery was performed on 27 patients with pituitary adenomas.
• Hormonal levels (growth hormone, prolactin, urinary free-cortisol) were measured pre- and post-operatively in 19 patients with functioning microadenomas.
• Tumor targeting and radiation dosage (25-75 Gy) were precisely managed using advanced neuroimaging.

Main Results:

• Hormonal normalization was achieved in 6 patients within 10 months.
• 6 additional patients showed significant hormonal reduction (>50%), indicating potential remission.
• Reduction in hormone secretion began within 1-3 months post-radiosurgery, with symptom improvement.

Conclusions:

• Gamma Knife radiosurgery demonstrates a potential therapeutic role in controlling hormone hypersecretion in pituitary microadenomas.
• Radiosurgery offers a promising option for managing pituitary microadenomas, potentially complementing transsphenoidal surgery.
• Further follow-up is required to confirm long-term tumor control and hormonal efficacy.