Journal of Korean Neurosurgical Society
- Volume 29 Issue 3
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- Pages.336-344
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- 2000
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- 2005-3711(pISSN)
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- 1598-7876(eISSN)
The Role of Gamma Knife Radiosurgery for Prolactin Secreting Pituitary Adenomas
유즙 호르몬 과분비 선종에 대한 감마 나이프 수술의 역할
- Hur, Jin Woo (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
- Lim, Young Jin (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
- Leem, Won (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
- Yang, Jae Young (Department of Neurosurgery, Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University) ;
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Koh, Jun Seok
(Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
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Kim, Tae Sung
(Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
- Rhee, Bong Arm (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
- Kim, Gook Ki (Department of Neurosurgery, School of Medicine, Kyung Hee University)
- 허진우 (경희대학교 의과대학 신경외과학교실) ;
- 임영진 (경희대학교 의과대학 신경외과학교실) ;
- 임언 (경희대학교 의과대학 신경외과학교실) ;
- 양재영 (성균관대학교 의과대학 강북삼성병원 신경외과) ;
-
고준석
(경희대학교 의과대학 신경외과학교실) ;
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김태성
(경희대학교 의과대학 신경외과학교실) ;
- 이봉암 (경희대학교 의과대학 신경외과학교실) ;
- 김국기 (경희대학교 의과대학 신경외과학교실)
- Received : 1999.06.29
- Accepted : 1999.09.20
- Published : 2000.03.28
Abstract
Objective : The treatment for prolactin secreting pituitary adenoma(prolactinoma) include pharmacology, surgery, radiation therapy or radiosurgery. The recent development of radiological imaging and microsurgery has made transsphenoidal microsurgery the treatment of choice for most prolactin secreting pituitary adenoma. Despite its low morbidity and mortality, relatively high recurrence and failure rate have been reported. Recent advances in neuroimaging provide a precise targeting in radiosurgery for treatment of prolactin secreting pituitary adenoma. In this regard, Gamma knife radiosurgery has been proposed as an alternative primary treatment modality or adjuvant therapy. Patients and Methods : Twenty three patients with prolactin secreting pituitary adenoma have been treated with Gamma knife radiosurgery in our institute from March 1992 to September 1998. We analyzed clinical, radiological and endocrinological changes in 21 patients who were followed up for an average of 35.7 months. Results : The mean age was 34.9 years and 16 patients were treated with Gamma knife radiosurgery as primary treatment and 5 patients underwent Gamma knife radiosurgery for residual tumors after microsurgery. The margin of the tumor was incorporated within the 40 to 80% and the mean marginal dose was 24.5 Gy. Clinical improvement in the last follow-up were present in 17 cases(81.0%) and 3 of 5 infertility patients became pregnant after Gamma knife radiosurgery. Tumor control rate after Gamma knife radiosurgery was 100%. Endocrinological normalization in the last follow-up were obtained in 12 cases(57.1%). In three cases, hormonal normalizations were present in early period(3-32 months) but serum hormone levels were elevated subsequently. Conclusion : We conclude that the Gamma knife radiosurgery for prolactin secreting pituitary adenoma seems to be safe and effective as adjuvant therapy after microsurgery and primary treatment modality in selective patients.