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The Role of Aberrant DNA Methylation in Misregulation of Gene Expression in Gonadotroph Nonfunctioning Pituitary Tumors
Open AccessArticle

Toxicity Profiles of Fractionated Radiotherapy, Contemporary Stereotactic Radiosurgery, and Transsphenoidal Surgery in Nonfunctioning Pituitary Macroadenomas

1
Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 106, Taiwan
2
Department of Hemato-Oncology, Wan Fang Hospital, Taipei Medical University, Taipei 106, Taiwan
3
Department of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei 106, Taiwan
4
Ph.D. Program for Translational Medicine, Taipei Medical University, Taipei, Taiwan
5
Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
6
Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
7
Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 106, Taiwan
*
Author to whom correspondence should be addressed.
These authors have contributed equally to this study.
Cancers 2019, 11(11), 1658; https://doi.org/10.3390/cancers11111658
Received: 14 September 2019 / Revised: 24 October 2019 / Accepted: 24 October 2019 / Published: 26 October 2019
Background: Here, we compared the toxicity profiles of contemporary stereotactic radiosurgery (SRS), modern fractionated radiotherapy (FRT), and transsphenoidal surgery used to treat nonfunctioning pituitary macroadenomas. Methods: We included the data of patients with nonfunctioning pituitary macroadenomas. To compare treatment outcomes, the patients were categorized groups 1 (those receiving modern FRT), 2 (those receiving contemporary SRS), and 3 (those receiving transsphenoidal surgery). The multivariable Cox proportional hazards regression analysis was performed to yielded adjusted hazard ratios (aHRs) and their 95% CIs for local recurrence in groups 2 and 3 compared with group 1. Results: We included the data of 248 patients with nonfunctioning pituitary macroadenomas. The analytical results revealed no significant differences in second primary brain or head and neck cancer, hypopituitarism, or optic nerve injury between the three cohorts. The multivariable Cox proportional hazards regression analysis revealed that compared with group 1, the aHRs (95% CIs) for stroke risk in groups 2 and 3 were 0.37 (0.14–0.99) and 0.51 (0.31–0.84), respectively. Conclusion: Contemporary SRS and transsphenoidal surgery for nonfunctioning pituitary macroadenoma treatment have equivalent toxicity profiles. However, modern FRT for nonfunctioning pituitary macroadenoma treatment might considerably increase stroke risk. View Full-Text
Keywords: nonfunctioning pituitary macroadenoma; transsphenoidal surgery; stereotactic radiosurgery; fractionated radiotherapy; toxicity; stroke nonfunctioning pituitary macroadenoma; transsphenoidal surgery; stereotactic radiosurgery; fractionated radiotherapy; toxicity; stroke
MDPI and ACS Style

Chang, C.-L.; Yuan, K. .-P.; Wu, A.T.; Wu, S.-Y. Toxicity Profiles of Fractionated Radiotherapy, Contemporary Stereotactic Radiosurgery, and Transsphenoidal Surgery in Nonfunctioning Pituitary Macroadenomas. Cancers 2019, 11, 1658.

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