interstitielle therapie bei hypophysenadenom

[mark]

bei meiner freundin wird ein hypophysenadenom (nicht hormonproduzierend) mit interstitieller therapie behandelt. gibt es in diesem zusammenhang studien, welche die wirksamkeit, bzw. die heilungsquoten durch diese art der therapie belegen? vielen dank für die antworten!

[Prof. Wust]

RE: interstitielle therapie bei hypophysenadenom


Der Einsatz der (externen) Radiotherapie ist beim Hypophysenadenom etabliert (s.u.). Die inter-stitielle Radiotherapie gehört im Prinzip dazu, hängt aber in höherem Maße von der Erfahrung und Geschicklichkeit des Therapeuten ab. Publizierte Studien gibt es dazu nicht bzw. sind mir nicht bekannt. In solchen Fällen ist es am besten, den Therapeuten selbst nach seinen bisherigen Erfahrungen und Ergebnissen zu fragen. Solche Eingriffe sind ohnehin recht personenabhängig.

Long-term results of radiation therapy for pituitary adenoma.
AU: Kokubo,-M; Sasai,-K; Shibamoto,-Y; Aoki,-T; Oya,-N; Mitsumori,-M; Takahashi,-J-A; Hashi-moto,-N; Hiraoka,-M
AD: Department of Therapeutic Radiology and Oncology, Graduate School of Medicine, Kyoto University, Shogoin, Sakyo, Japan. [email protected]
SO: J-Neurooncol. 2000 Mar; 47(1): 79-84
AB: PURPOSE: Local control for pituitary adenomas treated with external beam radiation therapy was retrospectively analyzed to evaluate the efficacy of radiation. MATERIALS AND METHODS: Thirty-eight patients treated with radiation therapy between 1979 and 1994 were analyzed. The median age was 46. Nineteen newly diagnosed tumors were treated with surgery and radiation therapy, while the others were recurrent cases. Twenty-two tumors were non-functioning, while 10 produced growth hormone (GH) and three each were prolactin-, and adre-nocorticotropic hormone (ACTH)-producing tumors. The median-radiation dose was 50 Gy in 25 fractions. RESULTS: Non-functioning adenomas and prolactin-producing adenomas were completely controlled, judging from the absence of tumor progression on neuroimaging studies and clinical symptoms, and normalization of the serum prolactin level (< 25 ng/ml). On the other hand, local control was obtained in only one of the 3 patients with ACTH-producing adenomas, and the control rate at 10 years was only 46% for GH-producing adenomas. Panhypopituitarism developed in 35% of the patients after radiation therapy. No other serious complications were noted. CONCLUSION: Non-functioning pituitary adenomas and prolactin-producing adenomas were well controlled with external radiation therapy combined with surgery. However, dose es-calation might be necessary to control GH-or ACTH-producing tumors. It is important to replace corticosteroid hormone and thyroid hormone in many patients.