Stereotactic Radiosurgery for Acromegaly: An International Multicenter Retrospective Cohort Study

Neurosurgery
Dale DingJason P Sheehan

Abstract

Stereotactic radiosurgery (SRS) is a treatment option for persistent or recurrent acromegaly secondary to a growth hormone secreting pituitary adenoma, but its efficacy is inadequately defined. To assess, in a multicenter, retrospective cohort study, the outcomes of SRS for acromegaly and determine predictors. We pooled and analyzed data from 10 participating institutions of the International Gamma Knife Research Foundation for patients with acromegaly who underwent SRS with endocrine follow-up of ≥6 mo. The study cohort comprised 371 patients with a mean endocrine follow-up of 79 mo. IGF-1 lowering medications were held in 56% of patients who were on pre-SRS medical therapy. The mean SRS treatment volume and margin dose were 3.0 cm3 and 24.2 Gy, respectively. The actuarial rates of initial and durable endocrine remission at 10 yr were 69% and 59%, respectively. The mean time to durable remission after SRS was 38 mo. Biochemical relapse after initial remission occurred in 9%, with a mean time to recurrence of 17 mo. Cessation of IGF-1 lowering medication prior to SRS was the only independent predictor of durable remission (P = .01). Adverse radiation effects included the development of ≥1 new endocrinopathy in 26% and ≥1 crania...Continue Reading

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Citations

Mar 5, 2020·The New England Journal of Medicine·Shlomo Melmed
Sep 22, 2019·Journal of Neuro-oncology·Clayton E AlonsoJason P Sheehan
Jan 16, 2020·Archives of Endocrinology and Metabolism·Raquel S Jallad, Marcello D Bronstein
Sep 12, 2020·Reviews in Endocrine & Metabolic Disorders·Andrea GiustinaShlomo Melmed
Jun 28, 2019·European Endocrinology·Elena V VarlamovMaria Fleseriu
May 23, 2020·Therapeutics and Clinical Risk Management·Giuliana CoricaFederico Gatto
Feb 18, 2020·Reviews in Endocrine & Metabolic Disorders·Frederic Castinetti
Jul 4, 2020·Endocrinology and Metabolism·Cheol Ryong KuEun Jig Lee
Sep 16, 2020·The Journal of Clinical Endocrinology and Metabolism·Xin LianFuquan Zhang
Mar 20, 2021·Hormones : International Journal of Endocrinology and Metabolism·Kiyohiko SakataMotohiro Morioka
Mar 30, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Mujdat KaraSelcuk Peker
May 6, 2021·Biomedicines·Samridhi Banskota, David C Adamson

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