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Patient-Reported Outcome (PRO) as an Addition to Long-Term Results after High-Precision Stereotactic Radiotherapy in Patients with Secreting and Non-Secreting Pituitary Adenomas: A Retrospective Cohort Study up to 17-Years Follow-Up

Authors
  • Kessel, Kerstin A.1, 2, 3
  • Diehl, Christian D.1
  • Oechsner, Markus1
  • Meyer, Bernhard3, 4
  • Gempt, Jens3, 4
  • Zimmer, Claus3, 5
  • Schmidt-Graf, Friederike
  • Combs, Stephanie E.1, 2, 3
  • 1 (S.E.C.)
  • 2 Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, 85764 Neuherberg, Germany
  • 3 (C.Z.)
  • 4 Department of Neurosurgery, Technical University of Munich (TUM), 81675 Munich, Germany
  • 5 Department of Neuroradiology, Technical University of Munich (TUM), 81675 Munich, Germany
Type
Published Article
Journal
Cancers
Publisher
MDPI AG
Publication Date
Nov 27, 2019
Volume
11
Issue
12
Identifiers
DOI: 10.3390/cancers11121884
PMID: 31783579
PMCID: PMC6966568
Source
PubMed Central
Keywords
License
Green

Abstract

High-precision radiotherapy has been established as a valid and effective treatment option in patients with pituitary adenomas. We report on outcome after fractionated stereotactic radiotherapy (FSRT) in correlation with patient-reported outcomes (PROs). We analyzed 69 patients treated between 2000 and 2019. FSRT was delivered with a median total dose of 54 Gy (single fraction: 1.8 Gy). PRO questionnaires were sent to 28 patients. Median overall survival was 17.2 years; mean local control was 15.6 years (median not reached). Median follow-up was 5.8 years. Twenty (71%) patients participated in the PRO assessment. Physicians reported symptoms grade ≥3 in 6 cases (9%). Of all, 35 (51%) patients suffered from hypopituitarism at baseline, and during follow-up, new or progressive hypopituitarism was observed in 11 cases (16%). Patients reported 10 cases of severe side effects. Most of these symptoms were already graded as CTCAE (Common Terminology Criteria for Adverse Events) grade 2 by a physician in a previous follow-up exam. PROs are an essential measure and only correlate to a certain extent with the physician-reported outcomes. For high-precision radiotherapy of pituitary adenomas, they confirm excellent overall outcomes and low toxicity. In the future, the integration of PROs paired with high-end treatment will further improve outcomes.

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