REVIEW OF 154 PATIENTS WITH NON-FUNCTIONING PITUITARY-TUMORS

A retrospective review was carried out on the charts of 154 patients with pituitary tumors that were not associated with Cushing's Disease or acromegaly. Patients were divided into three treatment groups: (1) surgery + post-operative radiation (S+R); (2) radiotherapy (R); and (3) surgery followed by radiation at the time of recurrence (S). Pretreatment evaluation revealed that patients in (S+R) had significantly larger tumors than patients in (R). However, there was no difference in the endocrinological status of patients prior to therapy in all treatment groups. The results of treatment were similar in the (S+R) and (R) treatment groups. This suggests that patients with small pituitary tumors may be treated successfully with radiation alone. Analysis of the recurrences revealed several reasons for failure of initial therapy, chiefly very large or locally aggressive tumors. Patients had recurrences up to 15 years after initial therapy. Therefore, follow-up of these patients should continue over a long period of time. Complications of each form of therapy were evaluated. Only one case of vascular occlusion was felt to be radiation-related. Long term steroid replacement therapy also was associated with complications. These included avascular necrosis of the femoral heads, gram negative sepsis and Addisonian crisis. The role of surgery as a single modality could not be assessed. © 1979.