Radiotherapy for pituitary adenomas: Long-term efficacy and toxicity
Radiotherapy for pituitary adenomas: Long-term efficacy and toxicity
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DOI：
10.1016/j.radonc.2009.09.011
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发表时间：
2009-12-01
影响因子：
5.7
通讯作者：
Gregor, Anna
中科院分区：
文献类型：
--
作者：
Erridge, Sara C.;Conkey, David S.;Gregor, Anna
背景：垂体腺瘤放射治疗是一种有效的治疗方法，但由于毒性问题仍存在争议。材料和方法对1974-2003年间接受放射治疗的患者进行了回顾性审计，检查了病例记录，并将数据与癌症登记和出院记录联系起来，以评估总生存期（OS）、无进展生存期（PFS）和后期效应（激素缺乏、视力下降、放射治疗和放射治疗）。结果385例患者接受放射治疗（中位45 Gy）， 10年和20年生存率分别为74%和49%，PFS为97%和96%。没有特定因素影响局部控制，19% （ACTH）和26% （TSH）发生额外激素缺乏。精算10年罕见视神经病变发生率为0.8% 78例患者发生中风。匹配的苏格兰人群的RR为男性145例（CI 1.05-1.18, p = 0.03），女性222例（CI 1.56 - 3.08, p < 0.01）。20年精算风险为1.9% (CI 0 ~ 2.6%)，男性为5.65 (0.53 ~ 2077,p= 0.10)，女性为994 （0.94 ~ 3656,p= 0.04）。结论该治疗有效，20年局部控制率良好，显著比例出现垂体功能低下。视神经病变的风险较低，但中风的风险增加，尤其是那些颅内肿瘤风险略有增加的女性（D 2009出版于Elsevier Ireland Ltd放疗与肿瘤学93 (2009)597-601）
Background Radiotherapy for pituitary adenomas is an effective treatment but remains controversial due to toxicity concernsMaterials and methods A retrospective audit of patients referred for radiotherapy during 1974-2003 was conducted, the case records were examined and data linkage to cancer registry and hospital discharge records was performed to assess the overall survival (OS), progression-free survival (PFS) and late effects (hormone deficiency, reduced vision, second cancer and stroke)Results Three hundred and eighty-five patients had radiotherapy (median 45 Gy) The OS was 74% and 49%, PFS was 97% and 96%, at 10 and 20 years, respectively. No specific factors Influenced local control Additional hormone deficiencies occurred in 19% (ACTH) and 26% (TSH). Actuarial rare optic neuropathy at 10 years was 0.8% Seventy-eight patients had a stroke. a RR for a matched Scottish population of 1 45 (CI 1.05-1.18, p = 0 03) men and 2 22 (1 56-3 08, p < 0 01) women Four intra-cranial tumours were identified; 20-year actuarial risk 1.9% (CI 0-2 6%), a RR of 5.65 (0.53-20 77, p=0 10) men and 994 (0 94-36 56, p = 0 04) womenConclusions This treatment is effective with good local control rates at 20 years A significant proportion developed hypo-pituitarism. The risk of optic neuropathy was low but risk of stroke increased, particularly in women who had slight increased risk of intra-cranial tumours (D 2009 Published by Elsevier Ireland Ltd Radiotherapy and Oncology 93 (2009) 597-601