Toxicity Profiles of Fractionated Radiotherapy, Contemporary Stereotactic Radiosurgery, and Transsphenoidal Surgery in Nonfunctioning Pituitary Macroadenomas
Background: Here, we compared the toxicity profiles of contemporary stereotactic radiosurgery (SRS), modern fractionated radiotherapy (FRT), and transsphenoidal surgery used to treat nonfunctioning pituitary macroadenomas. Methods: We included the data of patients with nonfunctioning pituitary macro...
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MDPI AG
2019-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/11/11/1658 |
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| author | Chia-Lun Chang Kevin Sheng-Po Yuan Alexander T.H. Wu Szu-Yuan Wu |
| author_facet | Chia-Lun Chang Kevin Sheng-Po Yuan Alexander T.H. Wu Szu-Yuan Wu |
| author_sort | Chia-Lun Chang |
| collection | DOAJ |
| description | Background: Here, we compared the toxicity profiles of contemporary stereotactic radiosurgery (SRS), modern fractionated radiotherapy (FRT), and transsphenoidal surgery used to treat nonfunctioning pituitary macroadenomas. Methods: We included the data of patients with nonfunctioning pituitary macroadenomas. To compare treatment outcomes, the patients were categorized groups 1 (those receiving modern FRT), 2 (those receiving contemporary SRS), and 3 (those receiving transsphenoidal surgery). The multivariable Cox proportional hazards regression analysis was performed to yielded adjusted hazard ratios (aHRs) and their 95% CIs for local recurrence in groups 2 and 3 compared with group 1. Results: We included the data of 248 patients with nonfunctioning pituitary macroadenomas. The analytical results revealed no significant differences in second primary brain or head and neck cancer, hypopituitarism, or optic nerve injury between the three cohorts. The multivariable Cox proportional hazards regression analysis revealed that compared with group 1, the aHRs (95% CIs) for stroke risk in groups 2 and 3 were 0.37 (0.14−0.99) and 0.51 (0.31−0.84), respectively. Conclusion: Contemporary SRS and transsphenoidal surgery for nonfunctioning pituitary macroadenoma treatment have equivalent toxicity profiles. However, modern FRT for nonfunctioning pituitary macroadenoma treatment might considerably increase stroke risk. |
| first_indexed | 2024-03-12T06:30:55Z |
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| id | doaj.art-49710125ef4246b3b88d56f5b5314977 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T06:30:55Z |
| publishDate | 2019-10-01 |
| publisher | MDPI AG |
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| series | Cancers |
| spelling | doaj.art-49710125ef4246b3b88d56f5b53149772023-09-03T01:38:37ZengMDPI AGCancers2072-66942019-10-011111165810.3390/cancers11111658cancers11111658Toxicity Profiles of Fractionated Radiotherapy, Contemporary Stereotactic Radiosurgery, and Transsphenoidal Surgery in Nonfunctioning Pituitary MacroadenomasChia-Lun Chang0Kevin Sheng-Po Yuan1Alexander T.H. Wu2Szu-Yuan Wu3Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 106, TaiwanDepartment of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei 106, TaiwanPh.D. Program for Translational Medicine, Taipei Medical University, Taipei, TaiwanDepartment of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, TaiwanBackground: Here, we compared the toxicity profiles of contemporary stereotactic radiosurgery (SRS), modern fractionated radiotherapy (FRT), and transsphenoidal surgery used to treat nonfunctioning pituitary macroadenomas. Methods: We included the data of patients with nonfunctioning pituitary macroadenomas. To compare treatment outcomes, the patients were categorized groups 1 (those receiving modern FRT), 2 (those receiving contemporary SRS), and 3 (those receiving transsphenoidal surgery). The multivariable Cox proportional hazards regression analysis was performed to yielded adjusted hazard ratios (aHRs) and their 95% CIs for local recurrence in groups 2 and 3 compared with group 1. Results: We included the data of 248 patients with nonfunctioning pituitary macroadenomas. The analytical results revealed no significant differences in second primary brain or head and neck cancer, hypopituitarism, or optic nerve injury between the three cohorts. The multivariable Cox proportional hazards regression analysis revealed that compared with group 1, the aHRs (95% CIs) for stroke risk in groups 2 and 3 were 0.37 (0.14−0.99) and 0.51 (0.31−0.84), respectively. Conclusion: Contemporary SRS and transsphenoidal surgery for nonfunctioning pituitary macroadenoma treatment have equivalent toxicity profiles. However, modern FRT for nonfunctioning pituitary macroadenoma treatment might considerably increase stroke risk.https://www.mdpi.com/2072-6694/11/11/1658nonfunctioning pituitary macroadenomatranssphenoidal surgerystereotactic radiosurgeryfractionated radiotherapytoxicitystroke |
| spellingShingle | Chia-Lun Chang Kevin Sheng-Po Yuan Alexander T.H. Wu Szu-Yuan Wu Toxicity Profiles of Fractionated Radiotherapy, Contemporary Stereotactic Radiosurgery, and Transsphenoidal Surgery in Nonfunctioning Pituitary Macroadenomas Cancers nonfunctioning pituitary macroadenoma transsphenoidal surgery stereotactic radiosurgery fractionated radiotherapy toxicity stroke |
| title | Toxicity Profiles of Fractionated Radiotherapy, Contemporary Stereotactic Radiosurgery, and Transsphenoidal Surgery in Nonfunctioning Pituitary Macroadenomas |
| title_full | Toxicity Profiles of Fractionated Radiotherapy, Contemporary Stereotactic Radiosurgery, and Transsphenoidal Surgery in Nonfunctioning Pituitary Macroadenomas |
| title_fullStr | Toxicity Profiles of Fractionated Radiotherapy, Contemporary Stereotactic Radiosurgery, and Transsphenoidal Surgery in Nonfunctioning Pituitary Macroadenomas |
| title_full_unstemmed | Toxicity Profiles of Fractionated Radiotherapy, Contemporary Stereotactic Radiosurgery, and Transsphenoidal Surgery in Nonfunctioning Pituitary Macroadenomas |
| title_short | Toxicity Profiles of Fractionated Radiotherapy, Contemporary Stereotactic Radiosurgery, and Transsphenoidal Surgery in Nonfunctioning Pituitary Macroadenomas |
| title_sort | toxicity profiles of fractionated radiotherapy contemporary stereotactic radiosurgery and transsphenoidal surgery in nonfunctioning pituitary macroadenomas |
| topic | nonfunctioning pituitary macroadenoma transsphenoidal surgery stereotactic radiosurgery fractionated radiotherapy toxicity stroke |
| url | https://www.mdpi.com/2072-6694/11/11/1658 |
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