Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review
Pituitary adenomas are often treated with radiotherapy for the management of tumor progression or recurrence. Despite the improvement in cure rates, patients treated by radiotherapy are at risk of development of secondary malignancies. We conducted a comprehensive literature review of the secondary...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2017-08-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/9/8/103 |
| _version_ | 1797710437276450816 |
|---|---|
| author | Ryuya Yamanaka Eisuke Abe Toshiteru Sato Azusa Hayano Yasuo Takashima |
| author_facet | Ryuya Yamanaka Eisuke Abe Toshiteru Sato Azusa Hayano Yasuo Takashima |
| author_sort | Ryuya Yamanaka |
| collection | DOAJ |
| description | Pituitary adenomas are often treated with radiotherapy for the management of tumor progression or recurrence. Despite the improvement in cure rates, patients treated by radiotherapy are at risk of development of secondary malignancies. We conducted a comprehensive literature review of the secondary intracranial tumors that occurred following radiotherapy to pituitary adenomas to obtain clinicopathological characteristics. The analysis included 48 neuroepithelial tumors, 37 meningiomas, and 52 sarcomas which were published between 1959–2017, although data is missing regarding overall survival and type of irradiation in a significant proportion of the reports. The average onset age for the pituitary adenoma was 37.2 ± 14.4 years and the average latency period before the diagnosis of the secondary tumor was 15.2 ± 8.7 years. Radiotherapy was administered in pituitary adenomas at an average dose of 52.0 ± 19.5 Gy. The distribution of pituitary adenomas according to their function was prolactinoma in 10 (7.2%) cases, acromegaly in 37 (27.0%) cases, Cushing disease in 4 (2.9%) cases, PRL+GH in 1 (0.7%) case, non-functioning adenoma in 57 (41.6%) cases. Irradiation technique delivered was lateral opposing field in 23 (16.7%) cases, 3 or 4 field technique in 27 (19.6%) cases, rotation technique in 10 (7.2%) cases, radio surgery in 6 (4.3%) cases. Most of the glioma or sarcoma had been generated after lateral opposing field or 3/4 field technique. Fibrosarcomas were predominant before 1979 (p < 0.0001). The median overall survival time for all neuroepithelial tumors was 11 months (95% confidence intervals (CI), 3–14). Patients with gliomas treated with radiotherapy exhibited a non-significant positive trend with longer overall survival. The median overall survival time for sarcoma cases was 6 months (95% CI, 1.5–9). The median survival time in patients with radiation and/or chemotherapy for sarcomas exhibited a non-significant positive trend with longer overall survival. In patients treated with radiotherapy for pituitary adenomas, the risk of secondary tumor incidence warrants a longer follow up period. Moreover, radiation and/or chemotherapy should be considered in cases of secondary glioma or sarcoma following radiotherapy to the pituitary adenomas. |
| first_indexed | 2024-03-12T06:52:07Z |
| format | Article |
| id | doaj.art-8470e739cd7c4391bae870c0300106b3 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T06:52:07Z |
| publishDate | 2017-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-8470e739cd7c4391bae870c0300106b32023-09-03T00:12:16ZengMDPI AGCancers2072-66942017-08-019810310.3390/cancers9080103cancers9080103Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic ReviewRyuya Yamanaka0Eisuke Abe1Toshiteru Sato2Azusa Hayano3Yasuo Takashima4Laboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDivision of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8122, JapanDepartment of Radiology, Nagaoka Chuo General Hospital, Nagaoka 940-8653, JapanLaboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanLaboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanPituitary adenomas are often treated with radiotherapy for the management of tumor progression or recurrence. Despite the improvement in cure rates, patients treated by radiotherapy are at risk of development of secondary malignancies. We conducted a comprehensive literature review of the secondary intracranial tumors that occurred following radiotherapy to pituitary adenomas to obtain clinicopathological characteristics. The analysis included 48 neuroepithelial tumors, 37 meningiomas, and 52 sarcomas which were published between 1959–2017, although data is missing regarding overall survival and type of irradiation in a significant proportion of the reports. The average onset age for the pituitary adenoma was 37.2 ± 14.4 years and the average latency period before the diagnosis of the secondary tumor was 15.2 ± 8.7 years. Radiotherapy was administered in pituitary adenomas at an average dose of 52.0 ± 19.5 Gy. The distribution of pituitary adenomas according to their function was prolactinoma in 10 (7.2%) cases, acromegaly in 37 (27.0%) cases, Cushing disease in 4 (2.9%) cases, PRL+GH in 1 (0.7%) case, non-functioning adenoma in 57 (41.6%) cases. Irradiation technique delivered was lateral opposing field in 23 (16.7%) cases, 3 or 4 field technique in 27 (19.6%) cases, rotation technique in 10 (7.2%) cases, radio surgery in 6 (4.3%) cases. Most of the glioma or sarcoma had been generated after lateral opposing field or 3/4 field technique. Fibrosarcomas were predominant before 1979 (p < 0.0001). The median overall survival time for all neuroepithelial tumors was 11 months (95% confidence intervals (CI), 3–14). Patients with gliomas treated with radiotherapy exhibited a non-significant positive trend with longer overall survival. The median overall survival time for sarcoma cases was 6 months (95% CI, 1.5–9). The median survival time in patients with radiation and/or chemotherapy for sarcomas exhibited a non-significant positive trend with longer overall survival. In patients treated with radiotherapy for pituitary adenomas, the risk of secondary tumor incidence warrants a longer follow up period. Moreover, radiation and/or chemotherapy should be considered in cases of secondary glioma or sarcoma following radiotherapy to the pituitary adenomas.https://www.mdpi.com/2072-6694/9/8/103gliomameningiomapituitary adenomaradiation-induced intracranial tumorsarcoma |
| spellingShingle | Ryuya Yamanaka Eisuke Abe Toshiteru Sato Azusa Hayano Yasuo Takashima Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review Cancers glioma meningioma pituitary adenoma radiation-induced intracranial tumor sarcoma |
| title | Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review |
| title_full | Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review |
| title_fullStr | Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review |
| title_full_unstemmed | Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review |
| title_short | Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review |
| title_sort | secondary intracranial tumors following radiotherapy for pituitary adenomas a systematic review |
| topic | glioma meningioma pituitary adenoma radiation-induced intracranial tumor sarcoma |
| url | https://www.mdpi.com/2072-6694/9/8/103 |
| work_keys_str_mv | AT ryuyayamanaka secondaryintracranialtumorsfollowingradiotherapyforpituitaryadenomasasystematicreview AT eisukeabe secondaryintracranialtumorsfollowingradiotherapyforpituitaryadenomasasystematicreview AT toshiterusato secondaryintracranialtumorsfollowingradiotherapyforpituitaryadenomasasystematicreview AT azusahayano secondaryintracranialtumorsfollowingradiotherapyforpituitaryadenomasasystematicreview AT yasuotakashima secondaryintracranialtumorsfollowingradiotherapyforpituitaryadenomasasystematicreview |