• Chapter 3

    The purpose of the cross-sectional study in a large cohort of patients with non-functioning pituitary adenomas, presented in Chapter 3, was to determine whether the use of radiation therapy in the postoperative period has a significant effect on health-related quality of life (HRQoL) and cognitive function. Ninety NFA-patients, treated with surgery in the time period 1963-2005 at the University Medical Center Groningen, were eligible. Questionnaires on quality of life, mood, cognition, use of medication, presence of co-morbidity, and social status were sent to all patients by mail. Eighty-one patients (49 men and 32 women, median age 55 years) returned all questionnaires, yielding a response rate of 90%. Forty-six of them received radiation therapy after neurosurgery because of residual disease or re-growth. Average time between neurosurgery and radiation therapy was 8 months. The radiation schedule applied was a total dose of 45 to 50 Gray in a daily dosage of 1.8 – 2 Gray. Those patients who received radiation treatment did more frequently have a craniotomy, were younger at the time of surgery, and their duration of follow-up was longer. Furthermore, thyroid hormone substitution was more frequently necessary.
    The HRQoL-questionnaires were equally scored by patients who received radiation therapy and those who did not. Some domains of the questionnaires were better scored by patients, who received radiation therapy. No differences in cogni-tive function scores were observed between irradiated and non-irradiated patients. In comparison with the reference population, social functioning, vita-lity, general health perception, fatigue and depression scores were worse in the group of patients without radiation therapy. In patients who did undergo radiation therapy only, general health perception was less than in the reference Dutch population, whereas physical functioning, pain and anxiety seemed even better.
    In conclusion, no negative outcomes and even some limited positive effects in the perception of mental and physical health after radiation therapy were found in our cohort of patients with NFA. Our results are reassuring and do not suggest that radiation therapy applied after surgery in the treatment of NFA leads to reduced HRQoL or impaired cognition.

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