PITFALLS IN THE GAMMA KNIFE TREATMENT OF PITUITARY ADENOMAS

Abstract

Purpose In the multimodal treatment of pituitary adenomas Radiosurgery is mainly used as a secondary treatment after the medical treatment and neurosurgery. Yet the Gamma Knife Treatment isn’t possible without some risks and complications. Material and Methods In this retrospective study 841 treatments were included. The patients were treated in the Radiotherapy Laboratory of the “Bagdasar-Arseni” Emergency Clinical Hospital, between 2004 and 2024, initially using a Gamma Knife 4C device, then a Gamma Knife Perfection and now an Esprit model. Most of the cases underwent surgery beforehand. The purpose of the treatment was tumor growth control and, in functioning adenomas, hormone hypersecretion control with the preservation of normal pituitary functions and the normal functioning of surrounding structures. Due to the treatment guidelines, we used during the treatments, very few complications occurred. There were 7 cases of hypopituitarism, 3 cases of oculomotor palsies, 6 cases of pituitary apoplexy. There were no recorded cases of significant optic neuropathy or carotid stenosis. Results and Conclusions The Gamma Knife treatment determined, in almost all cases, the stopping of tumor growth and in most cases a reduction in tumor volume. Complications (optic neuropathy, hypopituitarism, damage to the nerves inside the cavernous sinus) were very scarce. Gamma Knife Radiosurgery, if basic rules are followed, is an efficient and safe method in the treatment of pituitary adenomas.

Keywords

• gamma knife
• pituitary adenomas
• complications
• risks