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
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patients
2.2. Treatment
2.3. Follow-Up and Patient-Reported Outcome (PRO)
2.4. Statistics
3. Results
3.1. Outcome
3.2. Toxicity
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Characteristic | Specification | N (%) | Median (Range) |
---|---|---|---|
Gender | Female | 30 (44%) | |
Male | 39 (56%) | ||
Age at RT [years] | 61 (28–87) | ||
Size | Macroadenoma | 66 (96%) | |
Microadenoma | 3 (4%) | ||
Immunohistochemical classification | PRL | 7 (10%) | |
GH | 5 (7%) | ||
ACTH | 5 (7%) | ||
PRL & GH | 2 (3%) | ||
FSH | 2 (3%) | ||
TSH | 1 (1%) | ||
Non-functioning | 47 (68%) | ||
RT type | Primary treatment | 12 (17%) | |
Salvage treatment | 57 (83%) | ||
PTV [mL] | 21.0 (1.9–124.5) | ||
Total dose [Gy] | 50.4 (45–54) |
Outcome | 3-year | 5-year | 8-year | 10-year | 15-year |
---|---|---|---|---|---|
OS | 95% | 90% | 86% | 79% | 65% |
LC | 97% | 92% | 87% | 87% | 87% |
CTCAE Grade | PRE RT | <6 Months | >6 Months to <24 Months | >2 Years | PRO | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n = 69 | n = 58 | n = 47 | n = 57 | n = 20 | |||||||||||||||
1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 | 1 | 2 | 3 | 4 | 1 | 2 | 3 | |
Pain | - | - | - | - | 2 | - | - | - | 2 | 1 | - | - | 2 | 1 | - | - | 4 | 1 | - |
(3%) | (4%) | (2%) | (4%) | (2%) | (20%) | (5%) | |||||||||||||
Fatigue | - | - | - | - | 9 | 2 | - | - | 2 | - | - | - | 6 | 7 | - | - | 7 | 5 | 2 |
(16%) | (3%) | (4%) | (11%) | (12%) | (35%) | (25%) | (10%) | ||||||||||||
Nausea/vomiting | - | - | - | - | 1 | - | - | - | 1 | - | - | - | 2 | - | - | - | 1 | - | - |
(2%) | (2%) | (4%) | (5%) | ||||||||||||||||
Skin problems/erythema | - | - | - | - | 3 | - | - | - | - | - | - | - | - | - | - | - | - | 1 | 1 |
(5%) | (5%) | (5%) | |||||||||||||||||
Edema | - | - | - | - | - | 1 | - | - | 1 | - | - | - | - | - | - | - | 1 | - | - |
(2%) | (2%) | (5%) | |||||||||||||||||
Sensory disorders | - | 1 | - | - | 5 | - | - | - | - | 2 | - | - | 1 | 5 | 1 | - | 1 | - | - |
(1%) | (9%) | (4%) | (2%) | (9%) | (2%) | (5%) | |||||||||||||
Motor disorders | 1 | 1 | - | - | 1 | 2 | - | - | 2 | - | - | - | 1 | 5 | - | - | 2 | - | 2 |
(1%) | (1%) | (2%) | (3%) | (4%) | (2%) | (9%) | (10%) | (10%) | |||||||||||
Weight loss | - | - | - | - | - | - | - | - | - | - | - | - | 1 | 2 | - | - | 3 | - | - |
(2%) | (4%) | (15%) | |||||||||||||||||
Seizures | - | - | - | - | 1 | - | - | - | - | - | - | - | 2 | 1 | - | - | 2 | - | - |
(2%) | (4%) | (2%) | (10%) | ||||||||||||||||
Headache | 5 | 3 | - | - | 8 | 1 | - | - | 5 | - | - | - | 4 | 1 | - | - | 4 | - | 1 |
(7%) | (4%) | (14%) | (2%) | (11%) | (7%) | (2%) | (20%) | (5%) | |||||||||||
Hair loss | - | - | - | - | 14 | - | - | - | - | - | - | - | - | - | - | - | 3 | 2 | - |
(24%) | (15%) | (10%) | |||||||||||||||||
Dizziness/vertigo | 3 | 1 | - | - | 8 | - | - | - | 1 | 2 | - | - | 1 | 3 | - | - | 3 | 2 | - |
(4%) | (1%) | (14%) | (2%) | (4%) | (2%) | (5%) | (15%) | (10%) | |||||||||||
Cognitive disorders | 1 | 1 | - | - | - | 1 | - | - | - | 1 | - | - | 6 | 4 | - | - | 5 | 1 | |
(1%) | (1%) | (2%) | (2%) | (11%) | (7%) | (25%) | (5%) | ||||||||||||
Trigeminal neuropathy | - | - | - | - | 1 | - | - | - | - | - | - | - | 1 | - | - | - | - | - | - |
(2%) | (2%) | ||||||||||||||||||
Facial neuropathy | 1 | - | - | - | - | - | - | - | - | - | - | - | 1 | 1 | - | - | - | - | - |
(1%) | (2%) | (2%) | |||||||||||||||||
Vision loss | 3 | 2 | - | 5 | 3 | 1 | - | - | - | 2 | 1 | -- | 2 | 5 | 2 | - | 5 | 2 | 3 |
(4%) | (3%) | (7%) | (5%) | (2%) | (4%) | (2%) | (4%) | (9%) | (4%) | (25%) | (10%) | (15%) | |||||||
Visual deficits | 11 | 8 | 3 | - | 5 | 3 | - | - | 1 | 1 | 1 | - | 1 | 3 | 1 | - | 3 | 1 | - |
(16%) | (12%) | (4%) | (9%) | (5%) | (2%) | (2%) | (2%) | (2%) | (5%) | (2%) | (15%) | (5%) | |||||||
Eye problems | 1 | 4 | - | - | 1 | - | - | - | 2 | 1 | - | - | 2 | 6 | - | - | 1 | - | - |
(1%) | (6%) | (2%) | (4%) | (2%) | (4%) | (11%) | (5%) | ||||||||||||
Smell/taste deficits | - | - | - | - | 1 | 2 | - | - | 1 | - | - | - | 2 | - | - | - | - | - | - |
(2%) | (3%) | (2%) | (4%) | ||||||||||||||||
Hypopituitarism | - | 35 | - | - | - | 3 | - | - | - | 2 | - | - | - | 6 | - | - | - | 1 | 1 |
(51%) | (5%) | (4%) | (11%) | (5%) | (5%) | ||||||||||||||
Pituitary gland hyperactivity | 2 | 5 | - | - | 1 | 1 | - | - | - | 1 | - | - | - | 2 | - | - | - | - | - |
(3%) | (7%) | (2%) | (2%) | (2%) | (4%) |
Symptom | Physician-Reported after RT | PRO | ||
---|---|---|---|---|
CTCAE Grade | 1/2 | 3 | 1/2 | 3 |
Pain | 6 | - | 5 | - |
(30%) | (25%) | |||
Fatigue | 8 | - | 12 | 2 |
(40%) | (60%) | (10%) | ||
Nausea/vomiting | 1 | - | 1 | - |
(5%) | (5%) | |||
Skin problems/erythema | 1 | - | 1 | 1 |
(5%) | (5%) | (5%) | ||
Edema | - | - | 1 | - |
(5%) | ||||
Sensory disorders | 3 | 1 | 1 | - |
(15%) | (5%) | (5%) | ||
Motor disorders | 2 | 2 | 2 | |
(10%) | (10%) | (10%) | ||
Weight loss | - | - | 3 | - |
(15%) | ||||
Seizures | 1 | - | 2 | - |
(5%) | (10%) | |||
Headache | 5 | - | 4 | 1 |
(25%) | (20%) | (5%) | ||
Hair loss | 7 | - | 5 | - |
(35%) | (25%) | |||
Dizziness/vertigo | 2 | - | 5 | - |
(10%) | (25%) | |||
Cognitive disorders | 1 | - | 6 | - |
(5%) | (30%) | |||
Trigeminal neuropathy | 2 | - | - | - |
(10%) | ||||
Facial neuropathy | - | - | - | - |
Vision loss | 3 | 1 | 7 | 3 |
(15%) | (5%) | (35%) | (15%) | |
Visual deficits | 5 | - | 4 | - |
(25%) | (20%) | |||
Eye problems | 4 | - | 1 | - |
(20%) | (5%) | |||
Smell/taste deficits | 1 | - | - | - |
(5%) | ||||
Hypopituitarism | 3 | - | 1 | 1 |
(15%) | (5%) | (5%) | ||
Pituitary gland hyperactivity | 1 | - | - | - |
(5%) |
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Kessel, K.A.; Diehl, C.D.; Oechsner, M.; Meyer, B.; Gempt, J.; Zimmer, C.; Schmidt-Graf, F.; Combs, S.E. 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. Cancers 2019, 11, 1884. https://doi.org/10.3390/cancers11121884
Kessel KA, Diehl CD, Oechsner M, Meyer B, Gempt J, Zimmer C, Schmidt-Graf F, Combs SE. 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. Cancers. 2019; 11(12):1884. https://doi.org/10.3390/cancers11121884
Chicago/Turabian StyleKessel, Kerstin A., Christian D. Diehl, Markus Oechsner, Bernhard Meyer, Jens Gempt, Claus Zimmer, Friederike Schmidt-Graf, and Stephanie E. Combs. 2019. "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" Cancers 11, no. 12: 1884. https://doi.org/10.3390/cancers11121884
APA StyleKessel, K. A., Diehl, C. D., Oechsner, M., Meyer, B., Gempt, J., Zimmer, C., Schmidt-Graf, F., & Combs, S. E. (2019). 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. Cancers, 11(12), 1884. https://doi.org/10.3390/cancers11121884