Effect of stereotactic radiosurgery on residual or relapsed pituitary adenoma: a systematic review and meta-analysis
Abstract
Background In pituitary tumors, the presence of residual tumor after transsphenoidal surgery and recurrence of the tumor after resection are frequent, and the best treatment is not well established. The effects and complications of stereotactic radiosurgery have not been extensively studied.Objective We aimed to reveal the effect of stereotactic radiosurgery on residual and recurrent adenomas.Methods A systematic review of the literature in the MEDLINE/PubMed, Cochrane Central Database, and Google Scholar was conducted using the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search was structured according to the PICOT (i.e., Participants, types of Interventions, Comparator between the treatments, types of Outcome measures, and Follow-up [Time of duration]) strategy. The methodologic quality assessment (risk of bias) was performed according to the Methodological Index for Non-Randomized Studies scale. The studies were grouped and analyzed after data extraction using the software "R".Results Twenty-six articles including 2315 patients were analyzed, with an average follow-up duration of 57.8 months and mean radiation marginal dose of 19.6 Gy. The overall tumor control rate was 95%, tumor reduction rate was 46%, and hormonal control rate was 67%. The side effects were evaluated.Conclusions Stereotactic radiosurgery was efficient in residual or recurrence tumor control, with few side effects, and is recommended for treating residual or recurrent tumors, both secreting and nonsecreting tumors. A limitation of this study is that there were no randomized trials included in the synthesis.
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A recent metanalysis suggested that radiosurgery resulted in fewer cases of hypopituitarism (incidence 26% and 8% for secreting and non-secreting tumours) than conventional radiotherapy.
“A recent metanalysis has suggested that radiosurgery resulted in fewer cases of hypopituitarism (hypopituitarism incidence of 26% and 8% for secreting tumours and non-secreting tumours, respectively) than conventional radiotherapy (Heringer et al., 2020).”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Heringer et al., 2020
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- Authors
- Heringer, L. C., Machado de Lima, M., Rotta, J. M., & Botelho, R. V.
- Affiliations
- Instituto de Assistência Médica ao Servidor Público Estadual (BR)
- Corresponding author
- Botelho, Ricardo Vieira
- Venue
- World Neurosurgery
- Publisher
- Elsevier BV
- Published
- 2020-04
- Volume
- 136
- Pages
- 374-381.e4
- ISSN
- 1878-8750 (ISSN-L)
- OpenAlex
- W2998141404
- Cited by
- 15
- References
- 44
- Citations by year
- 2025: 5 · 2024: 2 · 2022: 3 · 2021: 5
- FWCI
- 0.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- World Neurosurgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Epidemiology › Meningioma and schwannoma management
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Keywords
- stereotactic radiosurgery, pituitary adenoma, residual tumor, recurrent tumor, tumor control, hormonal regulation, radiation side effects, transsphenoidal surgery
- MeSH terms
- Adenoma, Humans, Neoplasm Recurrence, Local, Pituitary Neoplasms, Radiosurgery, Treatment Outcome, Neoplasm, Residual
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