55P - Toxicity profiles of treatment with modern fractionated radiotherapy, contemporary stereotactic radiosurgery, or transsphenoidal surgery in non-functioning pituitary macroadenoma

Background

To compare the toxicity profiles of contemporary stereotactic radiosurgery (SRS), fractionated radiotherapy (FRT) with modern techniques, or transsphenoidal surgery on nonfunctioning pituitary macroadenoma.

Methods

We enrolled patients with nonfunctioning pituitary macroadenoma and categorized them into three groups according to treatment modality to compare treatment outcomes: group 1, those receiving modern FRT; group 2, those receiving contemporary SRS; and group 3, that receiving transsphenoidal surgery.

Results

248 patients in total with nonfunctioning pituitary macroadenoma were selected in our study. In multivariable Cox proportional hazards regression analysis, adjusted HRs (aHRs; 95% confidence interval [CI]) of local recurrence were derived for the SRS and transsphenoidal surgery cohorts compared with the FRT cohort was no significant difference in secondary primary brain or head and neck cancers, hypopituitarism, and optic nerve injury between three treatment cohorts. In multivariable Cox proportional hazards regression analysis, adjusted HRs (aHRs; 95% confidence interval [CI]) of stroke risk were derived for the SRS and transsphenoidal surgery cohorts compared with the FRT cohort were 0.37 (0.14-0.99) and 0.51 (0.31-0.84), respectively.

Conclusions

Contemporary SRS and transsphenoidal surgery in treatment of nonfunctioning pituitary macroadenoma would bring in equal toxicity profiles. Modern FRT might increase risk of stroke in treatment of nonfunctioning pituitary macroadenoma significantly.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.