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Hypophysenadenome

  • Harun Badakhshi
Chapter
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Zusammenfassung

Hypophysenadenome (HA) sind benigne Läsionen. Infolge morphologischer adenomatöser Veränderung kann es zur Störung aller relevanten Drüsenfunktionen kommen. HA machen etwa 70 % der von der Hypophyse stammenden Läsionen aus, zerebral beträgt der HA-Anteil 15 %. Klinik: Erstens Anwesenheit oder Abwesenheit der Hormonsekretion, zweitens neurologische Symptome infolge des lokalen Wachstums und drittens Zufallsbefunde in der Bildgebung. Therapieziel sollten die Reduktion der hormonalen Sekretion und der damit zusammenhängenden Symptome sowie die Volumenreduktion und der damit zusammenhängende Masseneffekt sein, in dessen Folge die endokrine Dysfunktion korrigierbar wäre. Die aktuelle Literatur weist auf die Wirksamkeit der stereotaktischen Radiochirurgie und multifraktionierten Modalitäten als nicht-invasive, sichere und kosteneffektive Methode hin. Die Kontrollraten liegen bei Prolaktinomen bei 20–30 %, bei STA-sezernierenden Läsionen 50 %, bei adrenokortikotropen hormonaktiven Läsionen bei 40–65 % und radiografische Kontrollraten bei ≤90 %.

Literatur

  1. Abu Dabrh AM, Asi N, Farah WH, Mohammed K, Wang Z, Farah MH et al (2015) Radiotherapy Versus Radiosurgery in Treating Patients with Acromegaly: A Systematic Review and Meta-Analysis. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 21(8):943–956CrossRefGoogle Scholar
  2. Barber SM, Teh BS, Baskin DS (2015) Fractionated Stereotactic Radiotherapy for Pituitary Adenomas: Single-Center Experience in 75 Consecutive Patients. Neurosurgery PMID: 26657072Google Scholar
  3. Bir SC, Murray RD, Ambekar S, Bollam P, Nanda A (2015) Clinical and Radiologic Outcome of Gamma Knife Radiosurgery on Nonfunctioning Pituitary Adenomas. Journal of neurological surgery Part B, Skull base 76(5):351–357CrossRefPubMedPubMedCentralGoogle Scholar
  4. Bostrom JP, Meyer A, Pintea B, Gerlach R, Surber G, Lammering G et al (2014) Risk-adapted single or fractionated stereotactic high-precision radiotherapy in a pooled series of nonfunctioning pituitary adenomas: high local control and low toxicity. Strahlentherapie und Onkologie: Organ der Deutschen Rontgengesellschaft [et al] 190(12):1095–1103CrossRefGoogle Scholar
  5. Castinetti F, Regis J, Dufour H, Brue T (2016) Role of stereotactic radiosurgery in the management of pituitary adenomas. Nature reviews Endocrinology 6(4):214–223CrossRefGoogle Scholar
  6. Ding D, Starke RM, Sheehan JP (2014) Treatment paradigms for pituitary adenomas: defining the roles of radiosurgery and radiation therapy. Journal of neuro-oncology 117(3):445–457CrossRefPubMedGoogle Scholar
  7. Elamin MB, Murad MH, Mullan R, Erickson D, Harris K, Nadeem S et al (2008) Accuracy of diagnostic tests for Cushing's syndrome: a systematic review and metaanalyses. The Journal of clinical endocrinology and metabolism 93(5):1553–1562CrossRefPubMedGoogle Scholar
  8. Faria C, Rito M, De Momi E, Ferrigno G, Bicho E (2015) Review of Robotic Technology for Stereotactic Neurosurgery. IEEE reviews in biomedical engineering 8:125–137CrossRefPubMedGoogle Scholar
  9. Gomez-Hernandez K, Ezzat S, Asa SL, Mete O (2015) Clinical Implications of Accurate Subtyping of Pituitary Adenomas: Perspectives from the Treating Physician. Turk patoloji dergisi 31 Suppl 1:4–17PubMedGoogle Scholar
  10. Gopalan R, Schlesinger D, Vance ML, Laws E, Sheehan J (2011) Long-term outcomes after Gamma Knife radiosurgery for patients with a nonfunctioning pituitary adenoma. Neurosurgery. 69(2):284–293CrossRefPubMedGoogle Scholar
  11. Granov AM, Shalek RA, Karlin DL, Vinogradov VM, Ialynych NN, Pushkareva TV et al (2013) [The results of proton radiosurgery for pituitary endosellar adenomas]. Voprosy onkologii 59(4):465–469PubMedGoogle Scholar
  12. Grant RA, Whicker M, Lleva R, Knisely JP, Inzucchi SE, Chiang VL (2014) Efficacy and safety of higher dose stereotactic radiosurgery for functional pituitary adenomas: a preliminary report. World neurosurgery 82(1–2):195–201CrossRefPubMedGoogle Scholar
  13. Hasegawa T, Shintai K, Kato T, Iizuka H (2015) Stereotactic Radiosurgery as the Initial Treatment for Patients with Nonfunctioning Pituitary Adenomas. World neurosurgery 83(6):1173–1179CrossRefPubMedGoogle Scholar
  14. Iwata H, Sato K, Tatewaki K, Yokota N, Inoue M, Baba Y et al (2011) Hypofractionated stereotactic radiotherapy with CyberKnife for nonfunctioning pituitary adenoma: high local control with low toxicity. Neuro-oncology 13(8):916–922CrossRefPubMedPubMedCentralGoogle Scholar
  15. Kajiwara K, Saito K, Yoshikawa K, Ideguchi M, Nomura S, Fujii M et al (2010) Stereotactic radiosurgery/radiotherapy for pituitary adenomas: a review of recent literature. Neurologia medico-chirurgica 50(9):749–755CrossRefPubMedGoogle Scholar
  16. Khamlichi AE, Melhaoui A, Arkha Y, Jiddane M, Gueddari BK (2013) Role of gamma knife radiosurgery in the management of pituitary adenomas and craniopharyngiomas. Acta neurochirurgica Supplement 116:49–54PubMedGoogle Scholar
  17. Kim JO, Ma R, Akagami R, McKenzie M, Johnson M, Gete E et al (2013) Long-term outcomes of fractionated stereotactic radiation therapy for pituitary adenomas at the BC Cancer Agency. International journal of radiation oncology, biology, physics 87(3):528–533CrossRefPubMedGoogle Scholar
  18. Kim JW, Kim DG (2014) Stereotactic radiosurgery for functioning pituitary adenomas. World neurosurgery 82(1–2):58–59CrossRefPubMedGoogle Scholar
  19. Kim W, Clelland C, Yang I, Pouratian N (2012) Comprehensive review of stereotactic radiosurgery for medically and surgically refractory pituitary adenomas. Surgical neurology international 3(Suppl 2):S 79–89Google Scholar
  20. Kopp C, Theodorou M, Poullos N, Astner ST, Geinitz H, Stalla GK et al (2013) Fractionated stereotactic radiotherapy in the treatment of pituitary adenomas. Strahlentherapie und Onkologie: Organ der Deutschen Rontgengesellschaft [et al] 189(11):932–937CrossRefGoogle Scholar
  21. Lake MG, Krook LS, Cruz SV (2013) Pituitary adenomas: an overview. American family physician 88(5):319–327PubMedGoogle Scholar
  22. Lee CC, Chen CJ, Yen CP, Xu Z, Schlesinger D, Fezeu F et al (2014a) Whole-sellar stereotactic radiosurgery for functioning pituitary adenomas. Neurosurgery 75(3):227–237; discussion 237CrossRefPubMedGoogle Scholar
  23. Lee CC, Kano H, Yang HC, Xu Z, Yen CP, Chung WY et al (2014b) Initial Gamma Knife radiosurgery for nonfunctioning pituitary adenomas. Journal of neurosurgery 120(3):647–654CrossRefPubMedGoogle Scholar
  24. Lee CC, Vance ML, Lopes MB, Xu Z, Chen CJ, Sheehan J (2015b) Stereotactic radiosurgery for acromegaly: outcomes by adenoma subtype. Pituitary 18(3):326–334CrossRefPubMedGoogle Scholar
  25. Lee KM, Park SH, Park KS, Hwang JH, Hwang SK (2015a) Analysis of Circulating Endostatin and Vascular Endothelial Growth Factor in Patients with Pituitary Adenoma Treated by Stereotactic Radiosurgery: A Preliminary Study. Brain tumor research and treatment 3(2):89–94CrossRefPubMedPubMedCentralGoogle Scholar
  26. Liao HI, Wang CC, Wei KC, Chang CN, Hsu YH, Lee ST et al (2014) Fractionated stereotactic radiosurgery using the Novalis system for the management of pituitary adenomas close to the optic apparatus. Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia 21(1):111–115CrossRefGoogle Scholar
  27. Liscak R, Jezkova J, Marek J (2013) Stereotactic radiosurgery of pituitary adenomas. Neurosurgery clinics of North America 24(4):509–519CrossRefPubMedGoogle Scholar
  28. Mak HK, Lai SW, Qian W, Xu S, Tong E, Vance ML et al (2015) Effective time window in reducing pituitary adenoma size by gamma knife radiosurgery. Pituitary 18(4):509–517CrossRefPubMedGoogle Scholar
  29. Minniti G, Scaringi C, Amelio D, Maurizi Enrici R (2012) Stereotactic Irradiation of GH-Secreting Pituitary Adenomas. International journal of endocrinology:482861Google Scholar
  30. Minniti G, Scaringi C, Poggi M, Jaffrain Rea ML, Trillo G, Esposito V et al (2015) Fractionated stereotactic radiotherapy for large and invasive non-functioning pituitary adenomas: long-term clinical outcomes and volumetric MRI assessment of tumor response. European journal of endocrinology / European Federation of Endocrine Societies. 2015;172(4):433–41.CrossRefGoogle Scholar
  31. Park KJ, Kano H, Parry PV, Niranjan A, Flickinger JC, Lunsford LD et al (Long-term outcomes after gamma knife stereotactic radiosurgery for nonfunctional pituitary adenomas. Neurosurgery 69(6):1188–1199Google Scholar
  32. Puataweepong P, Dhanachai M, Hansasuta A, Dangprasert S, Sitathanee C, Swangsilpa T et al (2015) Outcomes for Pituitary Adenoma Patients Treated with Linac- Based Stereotactic Radiosurgery and Radiotherapy:a Long Term Experience in Thailand. Asian Pacific journal of cancer prevention: APJCP 16(13):5279–5284CrossRefPubMedGoogle Scholar
  33. Schalin-Jantti C, Valanne L, Tenhunen M, Setala K, Paetau A, Sane T et al (2010) Outcome of fractionated stereotactic radiotherapy in patients with pituitary adenomas resistant to conventional treatments: a 5.25-year follow-up study. Clinical endocrinology 73(1):72–77PubMedGoogle Scholar
  34. Scheick S, Amdur RJ, Kirwan JM, Morris CG, Mendenhall WM, Roper S et al (2016) Long-term Outcome After Fractionated Radiotherapy for Pituitary Adenoma: The Curse of the Secretory Tumor. American journal of clinical oncology 39(1):49–54CrossRefPubMedGoogle Scholar
  35. Sheehan JP. Stereotactic radiosurgery for functioning pituitary adenomas – a higher dose is better but only up to a point. World Neurosurg. 2014; 82(1-2):e75–6.Google Scholar
  36. Sheehan JP, Starke RM, Mathieu D, Young B, Sneed PK, Chiang VL et al (2013) Gamma Knife radiosurgery for the management of nonfunctioning pituitary adenomas: a multicenter study. Journal of neurosurgery 119(2):446–456CrossRefPubMedGoogle Scholar
  37. Sheehan JP, Xu Z, Lobo MJ (2012) External beam radiation therapy and stereotactic radiosurgery for pituitary adenomas. Neurosurgery clinics of North America 23(4):571–586CrossRefPubMedGoogle Scholar
  38. Stapleton CJ, Liu CY, Weiss MH (2010) The role of stereotactic radiosurgery in the multimodal management of growth hormone-secreting pituitary adenomas. Neurosurgical focus 29(4):E11CrossRefPubMedGoogle Scholar
  39. Starke RM, Williams BJ, Vance ML, Sheehan JP (2010) Radiation therapy and stereotactic radiosurgery for the treatment of Cushing's disease: an evidence-based review. Current opinion in endocrinology, diabetes, and obesity 17(4):356–364CrossRefPubMedGoogle Scholar
  40. Vincent A, Galle J, Martino A, Russo S, Ove R (2013) Hybrid intensity modulated radiotherapy – stereotactic radiosurgery for treatment of pituitary macroadenomas. Practical radiation oncology 3(2 Suppl 1):S18–19CrossRefPubMedGoogle Scholar
  41. Weber DC, Momjian S, Pralong FP, Meyer P, Villemure JG, Pica A (2011) Adjuvant or radical fractionated stereotactic radiotherapy for patients with pituitary functional and nonfunctional macroadenoma. Radiation oncology 6:169CrossRefPubMedPubMedCentralGoogle Scholar
  42. Wilson PJ, De-Loyde KJ, Williams JR, Smee RI (2012) A single centre's experience of stereotactic radiosurgery and radiotherapy for non-functioning pituitary adenomas with the Linear Accelerator (Linac). Journal of clinical neuroscience:official journal of the Neurosurgical Society of Australasia 9(3):370–374CrossRefGoogle Scholar
  43. Xu Z, Ellis S, Lee CC, Starke RM, Schlesinger D, Lee Vance M et al (2014) Silent corticotroph adenomas after stereotactic radiosurgery: a case-control study. International journal of radiation oncology, biology, physics 90(4):903–910CrossRefPubMedGoogle Scholar
  44. Xu Z, Lee Vance M, Schlesinger D, Sheehan JP (2013) Hypopituitarism after stereotactic radiosurgery for pituitary adenomas. Neurosurgery 72(4):630–637; 636–637CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Deutschland 2017

Authors and Affiliations

  • Harun Badakhshi
    • 1
  1. 1.Direktor der Klinik für integrative RadioonkologieKlinikum Ernst von Bergmann, akademisches Krankenhaus der CharitéPotsdamDeutschland

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