Gamma Knife Surgery in Pituitary Microadenomas

Yong Gou Park, JinWoo Chang, Eun Young Kim, Sang Sup Chung

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

The application of transsphenoidal microsurgery in the management of pituitary microadenoma, long regarded as effective surgical treatment, has had a relatively low mortality and morbidity rate. However early failure and late recurrence has been reported in no small numbers. It has been proposed that stereotactic radiosurgery is an alternative treatment modality. Recent advances in neuroimaging Permits precise targeting in radiosurgery of microadenomas. Additionally, a prompt hormonal reduction after the treatment is important for the patients with hormonally active microadenomas. The authors performed Gamma Knife radiosurgery in 27 patients with pituitary adenomas and observed the hormonal changes after radiosurgery in 19 patients with functioning microadenomas (5 with Cushing's disease, 7 with acromegaly, and 7 with prolactinoma). The maximum dose administered ranged from 25 to 75 Gy. The margin of the tumor was encompassed within the 50 to 90% isodose volume. The endocrinological status was assessed pre- and post-operatively. We measured the serum growth hormone and prolactin level, as well as the 24-hour urinary free-cortisol level. Normalization of the hormonal level was achieved in 6 cases, the majority of them within 10 months. The other 6 cases showed marked reduction of hormonal levels (less than 50% of preoperative levels) with a strong possibility of hormonal remission at further follow-up. The remaining 6 were failures. The cure for one case is still pending. It took approximately 1-3 months after the radiosurgery before the reduction of hormonal secretion began to show up with some improvement of symptoms. When the GKS was successful, hormonal secretion seemed to return to normal within 10 months. Although further follow-up is necessary to evaluate the long-term tumor control rate and hormonal effect, these initial results indicate a potential therapeutic role of radiosurgery in controlling hormone hypersecretion in pituitary microadenomas. Gamma knife radiosurgery is very promising in managing pituitary microadenoma with complementary of the transsphenoidal surgery.

Original languageEnglish
Pages (from-to)165-173
Number of pages9
JournalYonsei medical journal
Volume37
Issue number3
DOIs
Publication statusPublished - 1996 Jan 1

Fingerprint

Radiosurgery
Prolactinoma
Pituitary ACTH Hypersecretion
Acromegaly
Microsurgery
Pituitary Neoplasms
Licensure
Therapeutics
Neuroimaging
Prolactin
Growth Hormone
Hydrocortisone
Neoplasms
Hormones
Morbidity
Recurrence
Mortality
Serum

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Park, Yong Gou ; Chang, JinWoo ; Kim, Eun Young ; Chung, Sang Sup. / Gamma Knife Surgery in Pituitary Microadenomas. In: Yonsei medical journal. 1996 ; Vol. 37, No. 3. pp. 165-173.
@article{5dc9222a737a4883a013ac32e71640b1,
title = "Gamma Knife Surgery in Pituitary Microadenomas",
abstract = "The application of transsphenoidal microsurgery in the management of pituitary microadenoma, long regarded as effective surgical treatment, has had a relatively low mortality and morbidity rate. However early failure and late recurrence has been reported in no small numbers. It has been proposed that stereotactic radiosurgery is an alternative treatment modality. Recent advances in neuroimaging Permits precise targeting in radiosurgery of microadenomas. Additionally, a prompt hormonal reduction after the treatment is important for the patients with hormonally active microadenomas. The authors performed Gamma Knife radiosurgery in 27 patients with pituitary adenomas and observed the hormonal changes after radiosurgery in 19 patients with functioning microadenomas (5 with Cushing's disease, 7 with acromegaly, and 7 with prolactinoma). The maximum dose administered ranged from 25 to 75 Gy. The margin of the tumor was encompassed within the 50 to 90{\%} isodose volume. The endocrinological status was assessed pre- and post-operatively. We measured the serum growth hormone and prolactin level, as well as the 24-hour urinary free-cortisol level. Normalization of the hormonal level was achieved in 6 cases, the majority of them within 10 months. The other 6 cases showed marked reduction of hormonal levels (less than 50{\%} of preoperative levels) with a strong possibility of hormonal remission at further follow-up. The remaining 6 were failures. The cure for one case is still pending. It took approximately 1-3 months after the radiosurgery before the reduction of hormonal secretion began to show up with some improvement of symptoms. When the GKS was successful, hormonal secretion seemed to return to normal within 10 months. Although further follow-up is necessary to evaluate the long-term tumor control rate and hormonal effect, these initial results indicate a potential therapeutic role of radiosurgery in controlling hormone hypersecretion in pituitary microadenomas. Gamma knife radiosurgery is very promising in managing pituitary microadenoma with complementary of the transsphenoidal surgery.",
author = "Park, {Yong Gou} and JinWoo Chang and Kim, {Eun Young} and Chung, {Sang Sup}",
year = "1996",
month = "1",
day = "1",
doi = "10.3349/ymj.1996.37.3.165",
language = "English",
volume = "37",
pages = "165--173",
journal = "Yonsei Medical Journal",
issn = "0513-5796",
publisher = "Yonsei University College of Medicine",
number = "3",

}

Gamma Knife Surgery in Pituitary Microadenomas. / Park, Yong Gou; Chang, JinWoo; Kim, Eun Young; Chung, Sang Sup.

In: Yonsei medical journal, Vol. 37, No. 3, 01.01.1996, p. 165-173.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Gamma Knife Surgery in Pituitary Microadenomas

AU - Park, Yong Gou

AU - Chang, JinWoo

AU - Kim, Eun Young

AU - Chung, Sang Sup

PY - 1996/1/1

Y1 - 1996/1/1

N2 - The application of transsphenoidal microsurgery in the management of pituitary microadenoma, long regarded as effective surgical treatment, has had a relatively low mortality and morbidity rate. However early failure and late recurrence has been reported in no small numbers. It has been proposed that stereotactic radiosurgery is an alternative treatment modality. Recent advances in neuroimaging Permits precise targeting in radiosurgery of microadenomas. Additionally, a prompt hormonal reduction after the treatment is important for the patients with hormonally active microadenomas. The authors performed Gamma Knife radiosurgery in 27 patients with pituitary adenomas and observed the hormonal changes after radiosurgery in 19 patients with functioning microadenomas (5 with Cushing's disease, 7 with acromegaly, and 7 with prolactinoma). The maximum dose administered ranged from 25 to 75 Gy. The margin of the tumor was encompassed within the 50 to 90% isodose volume. The endocrinological status was assessed pre- and post-operatively. We measured the serum growth hormone and prolactin level, as well as the 24-hour urinary free-cortisol level. Normalization of the hormonal level was achieved in 6 cases, the majority of them within 10 months. The other 6 cases showed marked reduction of hormonal levels (less than 50% of preoperative levels) with a strong possibility of hormonal remission at further follow-up. The remaining 6 were failures. The cure for one case is still pending. It took approximately 1-3 months after the radiosurgery before the reduction of hormonal secretion began to show up with some improvement of symptoms. When the GKS was successful, hormonal secretion seemed to return to normal within 10 months. Although further follow-up is necessary to evaluate the long-term tumor control rate and hormonal effect, these initial results indicate a potential therapeutic role of radiosurgery in controlling hormone hypersecretion in pituitary microadenomas. Gamma knife radiosurgery is very promising in managing pituitary microadenoma with complementary of the transsphenoidal surgery.

AB - The application of transsphenoidal microsurgery in the management of pituitary microadenoma, long regarded as effective surgical treatment, has had a relatively low mortality and morbidity rate. However early failure and late recurrence has been reported in no small numbers. It has been proposed that stereotactic radiosurgery is an alternative treatment modality. Recent advances in neuroimaging Permits precise targeting in radiosurgery of microadenomas. Additionally, a prompt hormonal reduction after the treatment is important for the patients with hormonally active microadenomas. The authors performed Gamma Knife radiosurgery in 27 patients with pituitary adenomas and observed the hormonal changes after radiosurgery in 19 patients with functioning microadenomas (5 with Cushing's disease, 7 with acromegaly, and 7 with prolactinoma). The maximum dose administered ranged from 25 to 75 Gy. The margin of the tumor was encompassed within the 50 to 90% isodose volume. The endocrinological status was assessed pre- and post-operatively. We measured the serum growth hormone and prolactin level, as well as the 24-hour urinary free-cortisol level. Normalization of the hormonal level was achieved in 6 cases, the majority of them within 10 months. The other 6 cases showed marked reduction of hormonal levels (less than 50% of preoperative levels) with a strong possibility of hormonal remission at further follow-up. The remaining 6 were failures. The cure for one case is still pending. It took approximately 1-3 months after the radiosurgery before the reduction of hormonal secretion began to show up with some improvement of symptoms. When the GKS was successful, hormonal secretion seemed to return to normal within 10 months. Although further follow-up is necessary to evaluate the long-term tumor control rate and hormonal effect, these initial results indicate a potential therapeutic role of radiosurgery in controlling hormone hypersecretion in pituitary microadenomas. Gamma knife radiosurgery is very promising in managing pituitary microadenoma with complementary of the transsphenoidal surgery.

UR - http://www.scopus.com/inward/record.url?scp=0030157751&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030157751&partnerID=8YFLogxK

U2 - 10.3349/ymj.1996.37.3.165

DO - 10.3349/ymj.1996.37.3.165

M3 - Article

C2 - 8826781

AN - SCOPUS:0030157751

VL - 37

SP - 165

EP - 173

JO - Yonsei Medical Journal

JF - Yonsei Medical Journal

SN - 0513-5796

IS - 3

ER -