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Accueil > Bibliographie > Gamma Knife radiosurgery in pituitary adenomas : Why, who, and how to treat (...)

Gamma Knife radiosurgery in pituitary adenomas : Why, (...)

Discov Med. 2010 Aug ;10(51):107-11
Gamma Knife radiosurgery in pituitary adenomas : Why, who, and how to treat ?
Castinetti F, Brue T.

Pituitary adenomas are benign tumors that can be either secreting (acromegaly, Cushing’s disease, prolactinomas) or non-secreting. Transsphenoidal neurosurgery is the gold standard treatment ; however, it is not always effective. Gamma Knife radiosurgery is a specific modality of stereotactic radiosurgery, a precise radiation technique. Several studies reported the efficacy and low risk of adverse effects induced by this technique : in secreting pituitary adenomas, hypersecretion is controlled in about 50% of cases and tumor volume is stabilized or decreased in 80-90% of cases, making Gamma Knife a valuable adjunctive or first-line treatment. As hormone levels decrease progressively, the main drawback is the longer time to remission (12-60 months), requiring an additional treatment during this period. Hypopituitarism is the main side effect, observed in 20-40% cases. Gamma Knife is thus useful in the therapeutic algorithms of pituitary adenomas in well-defined indications, mainly low secreting small lesions well identified on magnetic resonance imaging (MRI).

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