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  • Title: Combined surgery and radiotherapy of invasive pituitary adenomas--problems of radiogenic encephalopathy.
    Author: Rauhut F, Stolke D.
    Journal: Acta Neurochir Suppl; 1996; 65():37-40. PubMed ID: 8738492.
    Abstract:
    The aim of the present study was to find out: can combined modality of surgery and local irradiation in case of invasive pituitary adenomas prevent tumour relapse and develop radiogenic late damage after this therapy. Thirty-three patients suffered from primary hypophysomas and twenty-three patients had pituitary tumour recurrences. In all cases combined therapy was performed. The long term results of 56 patients showed a recurrence rate of 5.4% (3 cases). The median follow-up time was 152 months, ranging from 101 to 197 months. Clinical and neuroradiological signs of radiogenic encephalopathy developed in 16 cases (28%). Because of slow progression, the exact beginning of the neurological symptoms was difficult to determine and varied from 7 to 11 years. The extent of the cerebral and endocrinological disturbances was very different but a marked effect of the optic nerve was not seen. It seems that the usual X-ray therapy with single doses of 1.8 Gy and total doses of 45-50 Gy have a high risk of radiogenic morbidity.
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