Cyberknife Radiotherapy for Pituitary Adenomas: Monitoring Response Using Magnetic Resonance Imaging
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Date
2018
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Abstract
INTRODUCTION: Our aim is to determine treatment response to Cyberknife based on follow-up MRI inpatients with pituitary adenoma.METHODS: We retrospectively identified the patients with pituitary adenoma treated with Cyberknife between2010 – 2014. Patients with postreatment eligible follow-up MRI scan after at least 6 months of Cyberknifetreatment were included in this study. Pre- and posttreatment MRI scans of 38 patients (male/female=1) wereretrospectively analysed to evaluate tumor response. Volumetric changes of the tumors, local control rate,volumetric changes over time and signal alterations on the surrounding brain parenchyma were assessed.RESULTS: The mean follow-up time of 38 patients was 25 months (range, 6-51 months). Significant meantumor volume reduction was found between pre- and posttreatment mean tumor volumes, which were 4722 mm3and 3475 mm3, respectively. There were 2 cases with radiological progression, 18 cases with stable disease and18 cases with regression. Thus, tumor local control rate was calculated as 94.7% in our study. There was also asignificant follow-up time difference between stable and radiological regression groups which indicates thatincreased follow-up time may be related with better volume decrease. Patient gender, additional medicaltreatment, age, the number of previous surgeries did not affect treatment response. Lastly, there was no case withsignal alteration on the surrounding brain parenchyma. DISCUSSION and CONCLUSION: Cyberknife is a known and effective treatment method in patients withpituitary adenoma. Our results also support that Cyberknife provides excellent local tumor control without anyradiological obvious side effects on surrounding tissues.