• Cerebrovascular disease (CVD)

    A relationship between radiation therapy for pituitary adenoma and (as a consequence) CVD has not been found66. Cerebral infarctions manifested at intervals of 3.2-14.6 years after RT. Three out of seven patients with cerebral infarction had evidence of vascular disease outside the treatment field. Only age was a negative prognostic factor.
    Out of 331 patients of The Royal Marsden cohort, 64 developed CVD after primary treatment of pituitary adenoma. In comparison with the normal population there was a relative risk of 4.1 (95% CI: 3.6-4.7%). The actuarial incidence of CVD after primary treatment of pituitary adenoma was 4% (95% CI: 2-7%) at 5 years, 11% (95% CI: 8-14%) at 10 years, and 21% (95% CI: 16-28%) at 20 years measured from the date of radiation therapy. In this cohort, age, radiation therapy dose and extent of surgery were independent predictors for CVD.
    Erfurth et al. stated that radiation therapy might act as a risk factor for CVD, but not stronger than other risk factors for CVD in all types of pituitary patients67. Until this moment it is not clear if applied radiation therapy is a risk factor in relation to CVD afterwards.

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