OBJECTIVE: This study evaluates the safety and efficacy of gamma knife radiosurgery (GKRS) in patients with a growth hormone-secreting adenoma. METHODS: A retrospective review of data collected from a prospective database of GKRS patients between January 1988 and September 2006 was performed in patients with acromegaly. Successful endocrine outcome was defined as normalization of the insulin-like growth factor level. Tumor volume was also assessed. At least 18 months of follow-up was available in 95 patients who received radiosurgery during the study period. Mean endocrine follow-up was 57 months (range, 18-168 mo). RESULTS: Normal insulin-like growth factor levels were achieved in 50 patients (53%) at an average time of 29.8 months after radiosurgery (median, 23.5 mo). A decrease in tumor volume control was achieved in 83 (92%) of 90 patients. Five patients (6%) had no change in tumor volume, and two patients (2%) had an increase in tumor volume. New endocrine deficiencies developed in 32 patients (34%). Four patients developed new-onset partial visual acuity deficits; three of these patients had received previous conventional fractionated radiation therapy. CONCLUSION: GKRS is a complementary treatment for recurrent or residual growth hormone-secreting pituitary adenomas. Although infrequent, tumor growth, new-onset pituitary hormone deficiency, recurrence, and neurological dysfunction require careful clinical, radiological, and endocrinological follow-up.
OBJECTIVE: This study evaluates the safety and efficacy of gamma knife radiosurgery (GKRS) in patients with a growth hormone-secreting adenoma. METHODS: A retrospective review of data collected from a prospective database of GKRS patients between January 1988 and September 2006 was performed in patients with acromegaly. Successful endocrine outcome was defined as normalization of the insulin-like growth factor level. Tumor volume was also assessed. At least 18 months of follow-up was available in 95 patients who received radiosurgery during the study period. Mean endocrine follow-up was 57 months (range, 18-168 mo). RESULTS: Normal insulin-like growth factor levels were achieved in 50 patients (53%) at an average time of 29.8 months after radiosurgery (median, 23.5 mo). A decrease in tumor volume control was achieved in 83 (92%) of 90 patients. Five patients (6%) had no change in tumor volume, and two patients (2%) had an increase in tumor volume. New endocrine deficiencies developed in 32 patients (34%). Four patients developed new-onset partial visual acuity deficits; three of these patients had received previous conventional fractionated radiation therapy. CONCLUSION: GKRS is a complementary treatment for recurrent or residual growth hormone-secreting pituitary adenomas. Although infrequent, tumor growth, new-onset pituitary hormone deficiency, recurrence, and neurological dysfunction require careful clinical, radiological, and endocrinological follow-up.
Authors: Jing Zeng; Alfred P See; Khaled Aziz; Saravanan Thiyagarajan; Tarek Salih; Rajendra P Gajula; Michael Armour; Jillian Phallen; Stephanie Terezakis; Lawrence Kleinberg; Kristen Redmond; Russell K Hales; Roberto Salvatori; Alfredo Quinones-Hinojosa; Phuoc T Tran; Michael Lim Journal: Cancer Biol Ther Date: 2011-10-01 Impact factor: 4.742
Authors: Henry Ka-Fung Mak; Shui-Wun Lai; Wenshu Qian; Stanley Xu; Elizabeth Tong; May Lee Vance; Edward Oldfield; John Jane; Jason Sheehan; Kelvin K W Yau; Max Wintermark Journal: Pituitary Date: 2015-08 Impact factor: 4.107
Authors: Nicholas J Szerlip; Yi-Chen Zhang; Dimitris G Placantonakis; Marc Goldman; Kara B Colevas; David G Rubin; Eric J Kobylarz; Sasan Karimi; Monica Girotra; Viviane Tabar Journal: Skull Base Date: 2011-07