Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Koerbler, V.
Radiochirurgische Bestrahlung von Hypophysenadenomen und Kraniopharyngeomen: Gamma-Knife vs. LINAC
Humanmedizin; [ Diplomarbeit ] 2; 2023. pp. 75
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Gellner Verena
- Mokry Michael
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- Abstract:
- Stereotactic radiosurgery has become a popular adjuvant treatment modality for pituitary adenomas and craniopharyngiomas. Today, a variety of irradiation techniques are on the forefront of sellar tumor therapy concepts. This paper’s primary objective is to critically compare the clinical results of 191 patients who underwent stereotactic radiosurgery with the Leksell Gamma-Knife and the modified linear accelerator (LINAC) at Graz state hospital between 1997 and 2016. To meet this objective, the paper presents a retrospective analysis of treatment plans and the past medical history over five years after radiation has been performed and includes the examination of tumor control, pituitary insufficiency and radiation-induced optic neuropathy (RON). In the course of data evaluation, the patient collectives of both radiation modalities showed a significant disparity in regard to group size and radiation regimen, which is why a clinical comparison of the treatment results had to be omitted. A descriptive evaluation of both groups’ results is provided and discussed instead. The substantial number of patients in the Leksell Gamma Knife group (n = 174) showed that 59% of pituitary adenomas with an indication for irradiation are hormone-inactive and that tumor control in hormone-inactive adenomas succeeds more frequently than in hormone-active adenomas (88.9 vs. 70.3%). In patients with craniopharyngioma, local tumor control was achieved in 88.9% of cases. The rates for endocrinological side effects indicate a particular sensitivity of the thyrotropic axis which, followed by the gonadotropic axis, accordingly required substitution more frequently (24% and 18.1%) than the corticotropic (15.9%) and somatotropic axis (6.3%). The data also reveals that radiogenic optic neuropathy is a rare but serious complication of radiosurgical irradiation with a complication rate of 2%. Overall, the results confirm that radiation for sellar tumor therapy yields excellent results with both the Leksell Gamma-Knife and LINAC-based systems and significantly improves patients’ prognoses.