Comparison of the efficacy of non-functional pituitary large adenomas in early and late GKRS treatment

IJonathan Pomeraniec and others analyzed the prognosis of gamma knife treatment for a totally extophanome-butterfly large adenoma to assess the effect of the timing of treatment on efficacy, the results of which were published in J Neurosurg in September 2018- From the article chapter
(Ref: Pomeraniec IJ, et alJ Neurosurg2018 Sep;129 (3): 648-657doi: 10.3171/2017.5 JNS163069Epub 2017 Oct 27gamma knife radiosurgery (GKRS) is commonly used to treat non-functional pitopillo large adenomas that are surgically residual or relapsedIs the timing of GKRS treatment early or late after surgery? After imaging discovers the progression of the tumor? No consensus has yet been reachedIJonathan Pomeraniec and others analyzed the prognosis of gamma knife treatment for a totally extophanome-butterfly large adenoma to assess the effect of the timing of treatment on efficacy, the results of which were published in J Neurosurg in September 2018the study conducted a multicenter retrospective analysis of patients with non-functional pituitary large adenomas treated with GKRS after nasal butterfly surgery in nine institutions owned by the International Gamma Knife Research Foundation from 1987 to 2015According to the characteristics of pituitary adenoma and radiosurgical parameters, 222 patients who met the study criteria were included from 496 patients, divided into two groups of GKRS treatment in early stage (after removal of 6 months) or advanced (after removal and 6 months), each group of 111 cases; And the analysis is layered at the interval between the last excision and the radiation surgeryresults showed no significant difference in the average volume of residual pituitary adenomas after surgery in the two groups, 4.1cm3 in the early group and 2.7cm3 (p-0.16) in the advanced groupAt 68.5 months of follow-up, the risk of tumor progression in the advanced group (p-0.013) and tumor residues (p-0.038) was greater than in the earlier groupThere was no significant difference in the incidence of endocrine disorders in early groups and in patients with advanced groups (p-0.68), and 30% of patients without endocrine dysfunction in the early group had endocrine disorders during follow-up and 27% in the late group (p-0.84) In patients with endocrine disorders, 14% of patients in the early group and 25% of patients in the advanced group gradually disappeared, with no significant difference between the two (p-0.32) authors believe that early GKRS treatment can delay the progression of non-functional pituitary large adenomas that are fully removed and do not increase the incidence of endocrine disorders compared to patients who undergo GKRS treatment late after surgery.