Group 1. In three out of 76 patients (4%), progression was observed after a median interval of 23 (16, 23 and 104, respectively) months after surgery. Local control rate was 95%
at 5 as well as at 10 years (Fig. 1). Local recurrence or regrowth was always intra/parasellar.
Group 2. In 16 out of 28 patients (57%), progression developed after a median interval of 30 (11-95) months. Local control rate was 49% and 22% at 5 and 10 years, respectively (Fig. 1). This was significantly worse than the local control rate among patients in Group 1 (p = 0.001). Fourteen of these 16 patients received “salvage” radiotherapy after a median interval of 38 months after the first neurosurgical procedure. Six patients received salvage radiotherapy immediately after diagnosis of regrowth, 7 patients after a second operation (4 craniotomy, 3 transsphenoidal procedure) and 1 patient after a third operation.

Figure 1 (click to view)

All patients had residual NFA after repeated operation. The radiation fractio-nation schedules used were 45 Gy in 25 fractions (n = 13) and 50 Gy in 25 fractions (n = 1). Local control rate after salvage radiotherapy at 5 and 10 years after first operation was 95%. In 2 patients, salvage radiotherapy was not applied because of cerebral infarction in one and acute death shortly after diagnosis of progression in the other.
Group 3. In 1 patient (6%) a recurrence developed 15 months after neurosurgery; this patient was treated with radiotherapy.