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Evaluation of the early endocrinological sequelae after hadron therapy on anterior skull base lesions in the adult population: a preliminary study
EANS Academy. Zoia C. 09/25/19; 275446; EP07005
Dr. Cesare Zoia
Dr. Cesare Zoia

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Abstract
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Background and purpose: Radiotherapy is increasingly assuming a pivotal role in the multimodal treatment of skull base lesions. Sadly, it may be burdened by relevant actinic damage to the pituitary function. One of the potential advantages of hadron therapy (HT) is its capacity of giving a higher dose of radiation on the target, while potentially sparing the sellar region. The aim of this study is to evaluate the early pituitary function of adult patients who underwent hadron therapy for anterior skull base lesions involving or adjacent to the pituitary gland.
Materials and methods: We retrospectively evaluated the scheduled endocrinological tests of all the patients referring to our national hadron therapy center for lesions of the anterior skull base.
Results: We evaluated 9 patients with a mean follow-up of 23 months. The treated lesions were 6 meningiomas, 1 craniopharyngioma, 1 undifferentiated carcinoma and 1 pituitary adenoma. Mean HT total dose was 54.2 ± 2.1 Gray (Gy), with a mean dose per fraction of 2.07 ± 0.5 Gy. Some kind of pituitary hormone alteration was reported for 3 patients, albeit only 1 of them was likely to be related to HT (11.1%). No patient experienced unexpected severe adverse events related to HT.
Conclusion: Hadron therapy performed on anterior skull base lesions seems to have a limited effect on the early pituitary function in the adult population. Further studies are needed to confirm the potential advantage of hadron therapy in reducing the invasiveness on pituitary function during the multimodal treatment of complex anterior skull base lesion.
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