Učinak radiokirurškog liječenja na funkcionalne tumore hipofize

master's thesis

• Title (english): Results of the radiosurgical treatment of functional pituitary adenomas
• Author: Kim Kasa
• Mentor: Tina Dušek (mentor)
• Committee member: Darko Kaštelan (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Tina Dušek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Adenomi hipofize su učestali tumori koji čine 10-15% svih intrakranijalnih tumora. S obzirom na funkcionalnost adenoma dijele se na funkcionalne i nefunkcionalne adenome, dok se funkcionalni dalje dijele na somatotropinome, kortikotropinome, prolaktinome, tireotropinome i gonadotropinome. Kod funkcionalnih adenoma dolazi do hipersekrecije hormona hipofize, pa određena vrsta funkcionalnih adenoma može, ovisno iz koje vrste stanica je nastala, izazvati specifičnu kliničku sliku. Prva linija liječenja funkcionalnih adenoma (osim prolaktinoma) je kirurško liječenje , dok je kod prolaktinoma to medikamentozna terapija dopaminskim agonistima. U liječenju rekurentnih tumora, postoperativnih rezidua, inoperabilnih tumora ili adenoma koji ne reagiraju adekvatno na medikamentoznu terapiju bitnu ulogu ima radioterapija (radiokirurško liječenje i konvencionalna radioterapija). Radiokirurško liječenje je specifično po tome što se korištenjem modernih uređaja, stereotaktičkih okvira, magnetne rezonance i radiokirurškog planiranja povećala preciznost zračenja i smanjila njegova doza, a pacijent zračenje može primiti u jednoj frakciji (SRS) ili frakcionirano u više doza (FSRS). U ovo retrospektivno istraživanje uključeno je 38 ispitanika s dijagnozom funkcionalnog adenoma hipofize (87% somatotropinoma, 13% prolaktinoma) koji su liječeni radiokirurški (87%) i konvencionalnom radioterapiju (13%) u KBC-u Zagreb od 1993. do 2019. godine. 44% ispitanika postiglo je potpunu funkcionalnu remisiju (45% somatotropinoma, 40% prolaktinoma), a rast adenoma je reguliran u 97% ispitanika (97% somatotropinoma, 100% prolaktinoma). Rezultati radiokirurškog liječenja i konvencionalne radioterapije u regulaciji rasta adenoma ne razlikuju se značajno, dok se razlika u postizanju funkcionalne remisije može pripisati malom uzorku ispitanika liječenih konvencionalnom radioterapijom.

Abstract (english)

Pituitary adenomas are common intracranial tumors that account for 10-15% of all intracranial tumors. They are divided by functionality into functional and nonfunctional adenoma, while functional adenoma are further divided into somatotropinoma, corticotropinoma, prolactinoma, thyreotropinoma and gonadotropinoma. Functional adenoma secretes large amounts of pituitary hormones, that can cause specific clinical symptoms, depending on which cell type adenoma is made out of. First-line therapy for functional pituitary adenoma (except prolactinoma) is surgical therapy, while in prolactinoma it is medical therapy with dopamine agonists. In treating recurrent tumors, residual tumors, inoperable tumors or medically untreatable tumors radiotherapy (radiosurgery and conventional radiotherapy) has an important role. Radiosurgery has, by using modern radiosurgical devices, stereotactic frames, magnetic resonance and radiosurgical planning, increased radiation accuracy and lowered radiation dose. In radiosurgery patients can receive radiation in one fraction (SRS) or in multiple fractions (FSRS). This retrospective study included 38 patients with diagnosed pituitary adenoma (87% somatotropinoma, 13% prolactinoma) that were treated radiosurgicaly (87%) and with conventional radiotherapy (13%) in KBC Zagreb from 1993. until 2019. 44% of patients were in complete biochemical remission after the treatment (45% somatotropinoma, 40% prolactionoma), while the growth of 97% of adenoma (97% somatotropinoma, 100% prolactinoma) was regulated. The results of radiosurgical and conventional radiotherapy show no significant difference in adenoma growth regulation, while the difference in functional remission can be associated with a small number of patients treated with conventional radiotherapy.

• Keywords: funkcionalni adenom hipofize; radiokirurško liječenje; konvencionalna radioterapija
• Keywords (english): functional pituitary adenoma; radiosurgical treatment; conventional radiotherapy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:999772
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-09-10 07:39:37