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Twenty-five patients(83 percent)had remissions during a median follow-up of 42 months(range,18 to 114).The remissions began 6 to 60 months after radiation therapy,but in most cases(22 patients)remission occurred during the first 2 years.None of the 25 patients had a relapse of Cushing's disease after remission was achieved.There was no relation between the response to radiotherapy and sex,age,urinary cortisol excretion before radiotherapy,the interval between surgery and radiotherapy,whether a pituitary adenoma was found by pathological examination,or tumor size. Seventeen patients had a deficiency of growth hormone after radiation therapy,10 had a deficiency of gonadotropins,4 had a deficiency of thyrotropin,and 1 had a deficiency of corticotropin.Pituitary irradiation is an effective and well-tolerated treatment for patients with Cushing's disease in whom transsphenoidal surgery is unsuccessful. |
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Cushing's syndrome
microsurgery,transsphenoidal
neoplasm,pituitary
neoplasm,pituitary,treatment of
pituitary,adenoma
pituitary,microadenoma
radiation therapy,CNS treatment and complications with
treatment of neurologic disorder
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