Skip to content
My WebMD Sign In, Sign Up

Brain Cancer Health Center

Font Size

Pituitary Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Adrenocorticotropic Hormone-Producing Pituitary Tumors Treatment

Standard Treatment Options for Adrenocorticotropic Hormone (ACTH)-Producing Pituitary Tumors

Standard treatment options for ACTH-producing pituitary tumors include the following:

Recommended Related to Brain Cancer

Brain Cancer Clinical Trials

Major pharmaceutical companies continually research and develop new medications and treatments for brain cancer, which must be shown to be safe and effective before doctors can prescribe them to patients. Through clinical trials, researchers test the effects of new medications on a group of volunteers with brain cancer. Following a strict protocol and using carefully controlled conditions, researchers evaluate the investigational drugs under development and measure the ability of the new drug to...

Read the Brain Cancer Clinical Trials article > >

  1. Surgery (usually a transsphenoidal approach).[1,2,3]
  2. Surgery plus radiation therapy.[1,2,4]
  3. Radiation therapy.[1,2,4]
  4. Steroidogenesis inhibitors, including mitotane, metyrapone, ketoconazole, and aminoglutethimide.[1,2,5]

For patients with corticotroph adenomas, transsphenoidal microsurgery is the treatment of choice.[1,2] Remission rates reported in most series are approximately 70% to 90%.[1] In a series of 216 patients, who were operated on using a transsphenoidal approach, 75% experienced long-term remission, 21% experienced persistence of Cushing disease, and 9% had recurrence after the initial correction of the hypercortisolism.[3] The average time interval for reoperation was 3.8 years. Seventy-nine percent of the tumors were microadenomas, and 18% were macroadenomas; 86% of the cases with microadenoma had long-term remission, whereas, only 46% of those with macroadenoma had remission. In cases in which hypercortisolemia persists, early repeat exploration and/or radiation therapy or laparoscopic bilateral adrenalectomy may be required.[2]

Radiation therapy has been used in patients who are deemed to be poor surgical candidates and has also been used as adjunctive therapy in patients with residual or recurrent active tumor.[1,4]

Drug therapy is considered to be an adjunct to transsphenoidal microsurgery in cases in which there is a residual tumor and in cases in which one is awaiting the effects of the radiation therapy.[1] Steroidogenesis inhibitors, including mitotane, metyrapone, ketoconazole, and aminoglutethimide are used. Ketoconazole is the best tolerated of these agents and is effective as monotherapy in about 70% of patients.[5]

If untreated, patients frequently succumb to cardiovascular disease or infection.

Treatment Options Under Clinical Evaluation for ACTH-Producing Pituitary Tumors

Treatment options under clinical evaluation for ACTH-producing pituitary tumors include the following:

  • Stereotactic radiation surgery.[4,6,7]

Current Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with pituitary tumor. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References:

  1. Yeh PJ, Chen JW: Pituitary tumors: surgical and medical management. Surg Oncol 6 (2): 67-92, 1997.
  2. Levy A: Pituitary disease: presentation, diagnosis, and management. J Neurol Neurosurg Psychiatry 75 (Suppl 3): iii47-52, 2004.
  3. Mampalam TJ, Tyrrell JB, Wilson CB: Transsphenoidal microsurgery for Cushing disease. A report of 216 cases. Ann Intern Med 109 (6): 487-93, 1988.
  4. Mahmoud-Ahmed AS, Suh JH: Radiation therapy for Cushing's disease: a review. Pituitary 5 (3): 175-80, 2002.
  5. Nieman LK: Medical therapy of Cushing's disease. Pituitary 5 (2): 77-82, 2002.
  6. Devin JK, Allen GS, Cmelak AJ, et al.: The efficacy of linear accelerator radiosurgery in the management of patients with Cushing's disease. Stereotact Funct Neurosurg 82 (5-6): 254-62, 2004.
  7. Wong GK, Leung CH, Chiu KW, et al.: LINAC radiosurgery in recurrent Cushing's disease after transsphenoidal surgery: a series of 5 cases. Minim Invasive Neurosurg 46 (6): 327-30, 2003.
1

WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
Next Article:

Today on WebMD

human brain xray
Article
Computed Tomography CT Scan Of The Head
Article
 
Integrative Medicine Cancer Quiz
Article
what is your cancer risk
Health Check
 

Malignant Gliomas
Article
Pets Improve Your Health
SLIDESHOW
 
Headache Emergencies
Video
life after a brain tumor
VIDEO
 

Would you consider trying alternative or complementary therapies?


WebMD Special Sections