Radiotherapy in Non-Functioning Pituitary Macroadenoma: Mansoura Experience

Abstract

OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning pituitary macroadenoma through the assessment of experience on clinical, biochemical, radiological features, and treatment outcome of patients, and to identify prognostic factors affecting progression-free survival (PFS).

METHODS Data of 55 patients with non-functioning pituitary macroadenoma presented to the Clinical Oncology and Nuclear Medicine department between 1998 and 2009 were investigated.

RESULTS The most common symptom was visual disturbance (38.2%) followed by headache (27.3%). The presence of male predominance was observed (1.4:1). Ten patients received radiotherapy (RT) only. Extrasellar extension was the more common treatment. The overall response rate was 72.8% with completed response at 16.4%. Memory and intellectual sequelae were the most common late complications of treatment (14%). The ten-year PFS was at 84.6%. PFS was found to be significantly better with higher dose of RT (up to 54 Gy), treatment by both surgery and RT, absence of visual field defect, and tumor localized to sella, whereas it was not significantly affected by age and sex.

CONCLUSION The data confirmed that the prevalence of mass effect and hypopituitarismin patients with non-functioning pituitary macroadenoma is elevated. Conventional external RT up to 54 Gy is safe and effective in controlling non-functioning pituitary macroadenoma with tolerable and acceptable morbidity.