The Effect of Chemoradiotherapy in Patients With Refractory Pituitary Adenomas
Pituitary Adenomas
About this trial
This is an interventional treatment trial for Pituitary Adenomas focused on measuring Temozolomide; radiotherapy; refractory pituitary adenomas
Eligibility Criteria
Inclusion Criteria:
Minimum Age: 18 Years Maximum Age: 80 Years
- Age ≥18 years, regardless of gender;
Meet the diagnostic criteria for refractory pituitary tumors;
- The tumor showed invasive growth on imaging and rapid growth, Ki-67 labeling index ≥3%;
- The tumor recurred within a short period of time (< 6months) after total resection;
- The tumor continues to grow after surgery and medical therapy;
- Systemic examination showed no metastases in the cranial canal or other systems throughout the body.
- Clinicopathological diagnosis of pituitary adenoma, and pathological tissue (wax or frozen tissue) can be obtained;
- Expected survival time ≥ 6 months;
- KPS score ≥70 points;
- Subjects who were able to read, understand, and sign written informed consent prior to participating in the study and were willing to comply with protocol requirements.
Exclusion Criteria:
Participants cannot participate in this study if they meet any of the following conditions:
- Subjects participated in clinical studies of other drugs or medical devices within 3 months before screening.
- Known to be allergic to temozolomide capsules;
- Have been diagnosed with pituitary carcinoma or have other malignant tumors;
- Have received radiation therapy for Sella region;
Those with severe acute and chronic diseases in various systems, whose conditions have not been effectively controlled, and whose conditions are unstable, including but not limited to:
- Patients with cardiac insufficiency (NYHA cardiac function grade ≥ 2), patients with severe heart disease such as cardiomyopathy, coronary heart disease, severe arrhythmia, etc. that are not effectively controlled;
- Severe active infections,
- Uncontrollable diabetes, hypertension / hypotension, cerebrovascular disease, gastric ulcer, respiratory disease, active autoimmune disease, etc .;
- History of any other diseases that the researcher judges to be unsuitable for the trial, etc .;
- For hepatic and renal insufficiency, hematological indicators: total bilirubin> 1.5 × ULN, ALT, AST> 2.5 × ULN; serum creatinine> 2 × ULN;
- Those with a neutrophil count of less than 1.5 × 109 / L, or a platelet count of less than 100 × 109 / L, or an HGB of less than 90g / L;
- Hepatitis B surface antigen, anti-HCV, anti-HIV or syphilis antibody positive;
- Those who need to take valproic acid and drugs that can cause bone marrow depression during the application or research period;
- pregnant or lactating women or those planning to become pregnant;
- People with history of difficulty in drawing blood;
- People with a history of bleeding disorders;
- Subjects had a history of drug use or smoking and alcohol abuse within 6 months before enrollment;
- Researchers do not consider it appropriate to participate in the trial.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Radiotherapy plus temozolomide
Radiotherapy plus placebo
Undergoing fractionated radiotherapy at a dose of 2 Gy per fraction given once daily five days per week for a total dose of 54 Gy, plus continuous daily temozolomide (75 mg per square meter of body-surface area per day), followed by six cycles of adjuvant temozolomide.
Radiotherapy treatment alone undergoing fractionated radiotherapy, total 54 Gy, 2GyX27, received placebo.