The incidence of second tumours and mortality in pituitary adenoma patients treated with postoperative radiotherapy versus surgery alone.

Abstract

To assess and compare the incidence of intra- and extracranial tumours and mortality in pituitary adenoma patients treated with postoperative radiotherapy and surgery alone. A total of 462 pituitary adenoma patients were treated between 1959 and 2008 at the University Medical Center Groningen in The Netherlands. Postoperative radiotherapy was administered on indication in 236 patients. The median follow-up time was 14 (range 1-49) years in patients treated with radiotherapy and 6 (range 1-34) years in patients treated with surgery alone. Three radiotherapy patients developed an intracranial tumour compared to one patient treated with surgery alone. The numbers of extracranial tumours per follow-up year were 6.5 (95% CI 2.5-10.5) and 5.1 (95% CI 1.9-8.2) in patients treated with and without a technique with vertex field and central body axis irradiation and 7.1 (CI 95% 2.9-11.2) in surgery alone patients. Forty-five patients treated with radiotherapy died compared to twenty-four patients treated with surgery alone (log-rank test RR 1.26, 95% CI 0.77-2.08, p=0.36). In this study postoperative radiotherapy and a radiotherapy treatment technique with vertex field and central body axis irradiation were not associated with an increased incidence of second tumours and mortality in pituitary adenoma patients.