Professional overview
for pituitary adenomas
1. Antisecretory effects of Gamma Knife radiosurgery
1.1 Growth-hormone-secreting pituitary adenomas
After first-line surgical treatment remission rate ranges from 44% to 74%.
When Gamma Knife radiosurgery (GKRS) is used hormone control was 51% at 5 years, 69% at 10 years, and 74% after 15 years.1
In some cases, traditional or open surgery is contraindicated or impossible, results are similar whether GKRS was used as a primary treatment (without surgery) or as an adjunctive treatment (after unsuccessful surgery), making it a possible alternative first-line treatment in cases where there are contraindications to surgery.
One of the main drawbacks of GKRS is that remission takes anything from 12 to 60 months and may need treatment with medications.
1.2 Adenomas and Cushing’s disease
Results following surgery for Cushing’s ranges from 50 to 80%, varying with the type of adenoma. When adjuvant Gamma Knife radiosurgery (GKRS) is applied within 3 months of surgery endocrine remission rates were 78% (p = 0.017).2
As is the case with growth hormone secreting tumours, the main drawback of the technique is the delay to remission, estimated to be 24–36 months, requiring efficacious medical treatment during this period to control excess cortisol signs.
1.3 Prolactin-secreting pituitary adenoma
2. Antitumoral effects of Gamma Knife radiosurgery
3. Adverse effects of Gamma Knife radiosurgery
3.1 The Risk of Hypopituitarism (too little secretion)
Post-SRS hypopituitarism was the most common treatment-related toxicity observed, at 21.0% (95% CI: 15.0–27.0%).