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PubMed1991

Photodynamic therapy for rat pituitary tumor in vitro and in vivo using pheophorbide-a and white light.

This is the first report on the use of photodynamic therapy (PDT) for rat pituitary tumor in vivo. Rat pituitary tumor (GH3) cells were cultured, GH3 tumor was subcutaneously implanted in nude mice, and pheophorbide-a (Ph-a) and white light were prepared. Photocytotoxicity proportional to Ph-a concentration, intensity of irradiation, and incubation time was observed in vitro. Despite the delay in the disappearance of Ph-a from the tumor, Ph-a in the pituitary gland rapidly decreased after intravenous administration in vivo. Through PDT, the tumor grossly disappeared, the plasma levels of rat growth hormone secreted from the tumor also remarkably decreased, and the development of giantism was inhibited. These results indicate that PDT is effective against rat pituitary tumor.

Animals↗
PubMed1994

Late sequelae in children treated for brain tumors and leukemia.

Forty-two survivors treated at an age of 2-16 years for brain tumors or leukemia were, 4-21 years after treatment, subjected to an extensive follow-up investigation, including physical examination and interview; 35 of them also had endocrinological and 33 psychological evaluation. Hormonal deficiencies were found in about two-thirds of patients and were most common in those treated for brain tumors. The great majority had verbal intelligence quotient (VIQ) within normal range. Also, the performance intelligence quotients (PIQ) were normal in most patients. However, the results suggested that the primary intellectual capacity in children treated for cancer was not being fully utilized, their PIQ being on the average higher than their VIQ; this tendency was especially pronounced in the leukemia patients.

Adolescent↗
PubMed2000

[Conventional and virtual simulation in retrobulbar irradiation].

BACKGROUND: Radiotherapy is commonly used in Grave's ophthalmopathy. The target volume encompasses the ocular muscles and the orbital tissue. The result of conventional simulation can be examined by means of CT simulation. PATIENTS AND METHODS: Twenty-five planning CTs with Grave's ophthalmopathy were studied. The conventional simulation of 4 x 4 cm2 lateral portals confined anteriorly by the fleshy canthus was performed on a CT-simulator using the observer's eye view (OEV) and digitally reconstructed radiographs (DRR). The coverage of the target volume and sparing of the eye lenses were studied on axial CT slices and multiplanar reconstructions (MPR). The distances between the apex of the orbita and cornea, fleshy canthus, and bony canthus were measured as well as the distance between cornea and posterior face of the lens. RESULTS: The pituitary gland and the ocular lenses were spared in each case (25/25). The orbita was entirely covered in 24 cases (96%). However, anterior parts of the external eye muscles were not completely encompassed in 7 cases (28%). The distance from the apex of the orbita to the cornea was 54.6 mm (53.3 to 55.8 mm, 95% confidence interval), to the fleshy canthus 40.3 mm (39.4 to 41.2 mm), and to the bony canthus 31.4 mm (30.2 to 32.5 mm). The distance between cornea and posterior face of the lens was 8.3 mm (7.9 to 8.7 mm). The distance between cornea and canthus differed significantly from normal eyes while the distance between cornea and posterior face of the lens was very similar to normal eyes. CONCLUSIONS: Conventional simulation of orbital irradiation with lateral fields confined anteriorly by the fleshy canthus ensures protection of the ocular lenses and the pituitary gland. However, anterior parts of the eye muscles may occasionally not completely be covered. The fleshy canthus and the cornea are more reliable landmarks as compared to the bony canthus.

Computer Simulation↗
PubMed2002

Radiosurgery for residual or recurrent nonfunctioning pituitary adenoma.

OBJECT: Nonfunctioning pituitary adenomas comprise approximately 30% of all pituitary tumors. The purpose of this retrospective study is to evaluate the efficacy and role of gamma knife radiosurgery (GKS) in the management of residual or recurrent nonfunctioning pituitary adenomas. METHODS: A review was conducted of the data obtained in 42 patients who underwent adjuvant GKS at the University of Pittsburgh between 1987 and 2001. Prior treatments included transsphenoidal resection, craniotomy and resection, or conventional radiotherapy. Endocrinological, ophthalmological, and radiological responses were evaluated. The duration of follow-up review varied from 6 to 102 months (mean 31.2 months). Fifteen patients were observed for more than 40 months. The mean radiation dose to the tumor margin was 16 Gy. Conformal radiosurgery planning was used to restrict the dose to the optic nerve and chiasm. Tumor control after GKS was achieved in 100% of patients with microadenomas and 97% of patients with macroadenomas. Gamma knife radiosurgery was equally effective in controlling adenomas with cavernous sinus invasion and suprasellar extension. No patient developed a new endocrinological deficiency following GKS. One patient's tumor enlarged with an associated decline in visual function. Another patient experienced a deterioration of visual fields despite a decrease in tumor size. CONCLUSIONS: Gamma knife radiosurgery can achieve tumor control in virtually all residual or recurrent nonfunctioning pituitary adenomas. Dose sparing facilitates tumor management even when the adenoma is close to the optic apparatus or invades the cavernous sinus.

Adenoma↗
PubMed1995

Thyroid abnormalities after therapeutic external radiation.

The thyroid gland is the largest pure endocrine gland in the body and one of the organs most likely to produce clinically significant abnormalities after therapeutic external radiation. Radiation doses to the thyroid that exceed approximately 26 Gy frequently produce hypothyroidism, which may be clinically overt or subclinical, as manifested by increased serum thyrotropin and normal serum-free thyroxine concentrations. Pituitary or hypothalamic hypothyroidism may arise when the pituitary region receives doses exceeding 50 Gy with conventional, 1.8-2 Gy fractionation. Direct irradiation of the thyroid may increase the risk of Graves' disease or euthyroid Graves' ophthalmopathy. Silent thyroiditis, cystic degeneration, benign adenoma, and thyroid cancer have been observed after therapeutically relevant doses of external radiation. Direct or incidental thyroid irradiation increases the risk for well-differentiated, papillary, and follicular thyroid cancer from 15- to 53-fold. Thyroid cancer risk is highest following radiation at a young age, decreases with increasing age at treatment, and increases with follow-up duration. The potentially prolonged latent period between radiation exposure and the development of thyroid dysfunction, thyroid nodularity, and thyroid cancer means that individuals who have received neck or pituitary irradiation require careful, periodic clinical and laboratory evaluation to avoid excess morbidity.

Humans↗