Temozolomide on Aggressive Pituitary Adenomas: About 4 Cases and Review of the Literature

Abstract

Pituitary adenomas represent 15 to 20% of all brain tumors . They affect 1/1000 of the world population, some pituitary adenomas with high Ki-67 indexes exhibit aggressive behaviors, such as rapid growth, early and frequent recurrence, and resistance to conventional treatment, even in the absence of metastasis . Many trials have focused on the role of chemotherapy in the treatment of these aggressive and atypical adenomas The objective: Monitoring of patients on temozolomide . we report the follow-up of 4 patients (pts) of 10 pts treated in our department during the period (2012-2019), 2 women / 2 men presenting an aggressive pituitary macro-adenoma, having benefited from excision surgery, radiotherapy and received medical treatment with temozolomide initiated with clinical, biological and radiological evaluation of the therapeutic response and search for p53 and ki 67 in the diagnosis. A clinical improvement was noted in our 4 pts; Radiologically: a partial response was obtained in 1pts, two stabilities and one progression . The average duration of treatment is 26 months (12 - 40) with manageable side effects .Temozolomide appears to be effective in the treatment of aggressive pituitary adenomas and may currently constitute a therapeutic alternative when all resources are exhausted, thus allowing control of the disease.