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Treatment of chromophobe adenomas with megavoltage irradiation
Author(s) -
Pistenma David A.,
Goffinet Don R.,
Bagshaw Malcolm A.,
Hanbery John W.,
Eltringham J. R.
Publication year - 1975
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197506)35:6<1574::aid-cncr2820350615>3.0.co;2-b
Subject(s) - medicine , chromophobe cell , radiation therapy , nuclear medicine , surgery , radiology , carcinoma , clear cell
From 1956–1972, 62 previously untreated patients with chromophobe adenomas received high‐dose (average equivalent dose: 5700 rads in 6 weeks) megavoltage (4–4.8 MeV) irradiation at Stanford, 33 postoperatively and 29 as the only intended treatment. Initial treatment failure rates were 18% and 41%, respectively; however, overall control was 85% and 90%, despite 2 uncontrolled “invasive” adenomas in each group. Nine of the 12 failures in the group treated by irradiation alone had cystic tumors, and 9 of the 12 “failed” in less than 3 months. Despite a considerably greater degree of abnormal vision initially in the postoperative irradiation group, improvement of vision with treatment in that group was 83% (39% returned to normal) compared to 46% (only 8% to normal) in the irradiation alone group. Based upon an evaluation of the extent of findings at diagnosis and our results, we recommend surgical decompression followed by 5000 rads in 5 weeks for patients with any one or more of the following findings: 1) more than minimal depression of peripheral visual fields; 2) corrected visual actuity of less than 20/30 in either eye; or 3) more than 1‐cm suprasellar extension of tumor. We recommend irradiation alone, as specified, for smaller adenomas accompanied by less extensive or no visual abnormalities.