Boldrey Ewin (1 results)

Am. J. Roentgenol. Radium. Ther. Nucl. Med., 92/1. - July 1964, pp.160-173, orig. brochure. Rare Offprint! "ALTHOUGH chromophobe adenomas are the most frequently encountered of the pituitary tumors and have been the subject of many reports, opinions regarding optimum therapy differ. Whereas most authors rely upon irradiation to control the growth of these adenomas, views vary on the necessity of preliminary operative decompression. Davidoff and Feiring prefer administering primary radiation therapy when a chromophobe adenoma is suspected. They reserve surgical operation for those patients with advanced visual loss, clinically atypical findings, radiation failure, or recurrence. Kerr1 and Correa and Lampe reported satisfactory responses in a majority of patients treated by irradiation alone. Both groups of patients, however, were so selected that many with the poorer prognoses were initially treated by operation. By contrast, Mogensen of Denmark used surgery on all chromophobe adenomas with postoperative radiation therapy added only in a selected few. In 1946, McWhirter et al. made the surprising statement that "chromophobe adenomas are no longer treated by radiotherapy for no conclusive evidence of their response to treatment has been obtained." Later, however, McWhirter and Dott stated that some chromophobe adenomas of the pituitary are radiosensitive and since surgical removal is never complete, suggested irradiation follow surgical decompression. Henderson found that in Cushing's series, the 5 year control rate increased from 57.5 to 87.1 per cent when radiation therapy followed the transfrontal operation. On reviewing Olivecrona's patients, Bakay' found "a rate of recurrence of io to 15 per cent." Most of these patients had been irradiated postoperatively. Richmond" and Heimbach' used radiation therapy after operative decompression for chromophobe adenomas. Authors advocating primary surgery for these adenomas generally emphasize the advantages of histologic verification of diagnosis and of immediate decompression. They accept the operative mortality and morbidity as a warranted risk. At the University of California Medical Center, San Francisco, primary operation usually has been performed whenever a chromophobe adenoma of the pituitary gland was suspected. The majority of these patients also received postoperative radiation. A small number has been treated by radiation alone, and a few, for one reason or another, have received no therapy. The present authors will review the data and discuss the results obtained in 95 previously untreated patients with chromophobe adenomas of the pituitary. Some of these patients were included in the review of Wise, Brown, Naffziger, and Boldrey." "From the Section of Therapeutic Radiology, Department of Radiology and the Division of Neurological Surgery, Department of Surgery, University of California School of Medicine, San Francisco, California. Presented at the Sixty-fourth Annual Meeting of The American Roentgen Ray Society, Montreal, Quebec, Canada, October 8-n 1963.".