Yi-Chieh Hung1,2,3, Cheng-Chia Lee4,5, Huai-Che Yang4, Nasser Mohammed1, Kathryn N Kearns1, Ahmed M Nabeel6,7, Khaled Abdel Karim6,8, Reem M Emad Eldin6,9, Amr M N El-Shehaby6,10, Wael A Reda6,10, Sameh R Tawadros6,10, Roman Liscak11, Jana Jezkova12, L Dade Lunsford13, Hideyuki Kano13, Nathaniel D Sisterson13, Roberto Martínez Álvarez14, Nuria E Martínez Moreno14, Douglas Kondziolka15, John G Golfinos15, Inga Grills16, Andrew Thompson16, Hamid Borghei-Razavi17, Tanmoy Kumar Maiti17, Gene H Barnett17, James McInerney18, Brad E Zacharia18, Zhiyuan Xu1, Jason P Sheehan1. 1. 1Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia. 2. 2Departments of Neurosurgery and Surgery, Chi-Mei Medical Center, Tainan. 3. 3Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy and Science, Tainan. 4. 4Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei. 5. 5School of Medicine, National Yang-Ming University, Taipei, Taiwan. 6. 6Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo. 7. 7Department of Neurosurgery, Benha University, Qalubya, Egypt. 8. 17Clinical Oncology, Ain Shams University, Cairo; and. 9. 18Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo, Egypt. 10. Departments of16Neurosurgery and. 11. 8Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague. 12. 9Department of Endocrinology and Metabolism, 3rd Department of Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic. 13. 10Department of Neurological Surgery, University of Pittsburgh, Pennsylvania. 14. 11Radiosurgery Unit, Hospital Ruber Internacional, Madrid, Spain. 15. 12Department of Neurosurgery, NYU Langone Health System, New York, New York. 16. 13Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan. 17. 14Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio. 18. 15Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Abstract
OBJECTIVE: The most common functioning pituitary adenoma is prolactinoma. Patients with medically refractory or residual/recurrent tumors that are not amenable to resection can be treated with stereotactic radiosurgery (SRS). The aim of this multicenter study was to evaluate the role of SRS for treating prolactinomas. METHODS: This retrospective study included prolactinomas treated with SRS between 1997 and 2016 at ten institutions. Patients' clinical and treatment parameters were investigated. Patients were considered to be in endocrine remission when they had a normal level of prolactin (PRL) without requiring dopamine agonist medications. Endocrine control was defined as endocrine remission or a controlled PRL level ≤ 30 ng/ml with dopamine agonist therapy. Other outcomes were evaluated including new-onset hormone deficiency, tumor recurrence, and new neurological complications. RESULTS: The study cohort comprised 289 patients. The endocrine remission rates were 28%, 41%, and 54% at 3, 5, and 8 years after SRS, respectively. Following SRS, 25% of patients (72/289) had new hormone deficiency. Sixty-three percent of the patients (127/201) with available data attained endocrine control. Three percent of patients (9/269) had a new visual complication after SRS. Five percent of the patients (13/285) were recorded as having tumor progression. A pretreatment PRL level ≤ 270 ng/ml was a predictor of endocrine remission (p = 0.005, adjusted HR 0.487). An increasing margin dose resulted in better endocrine control after SRS (p = 0.033, adjusted OR 1.087). CONCLUSIONS: In patients with medically refractory prolactinomas or a residual/recurrent prolactinoma, SRS affords remarkable therapeutic effects in endocrine remission, endocrine control, and tumor control. New-onset hypopituitarism is the most common adverse event.
OBJECTIVE: The most common functioning pituitary adenoma is prolactinoma. Patients with medically refractory or residual/recurrent tumors that are not amenable to resection can be treated with stereotactic radiosurgery (SRS). The aim of this multicenter study was to evaluate the role of SRS for treating prolactinomas. METHODS: This retrospective study included prolactinomas treated with SRS between 1997 and 2016 at ten institutions. Patients' clinical and treatment parameters were investigated. Patients were considered to be in endocrine remission when they had a normal level of prolactin (PRL) without requiring dopamine agonist medications. Endocrine control was defined as endocrine remission or a controlled PRL level ≤ 30 ng/ml with dopamine agonist therapy. Other outcomes were evaluated including new-onset hormone deficiency, tumor recurrence, and new neurological complications. RESULTS: The study cohort comprised 289 patients. The endocrine remission rates were 28%, 41%, and 54% at 3, 5, and 8 years after SRS, respectively. Following SRS, 25% of patients (72/289) had new hormone deficiency. Sixty-three percent of the patients (127/201) with available data attained endocrine control. Three percent of patients (9/269) had a new visual complication after SRS. Five percent of the patients (13/285) were recorded as having tumor progression. A pretreatment PRL level ≤ 270 ng/ml was a predictor of endocrine remission (p = 0.005, adjusted HR 0.487). An increasing margin dose resulted in better endocrine control after SRS (p = 0.033, adjusted OR 1.087). CONCLUSIONS: In patients with medically refractory prolactinomas or a residual/recurrent prolactinoma, SRS affords remarkable therapeutic effects in endocrine remission, endocrine control, and tumor control. New-onset hypopituitarism is the most common adverse event.
Authors: James R Janopaul-Naylor; Manali Rupji; Jim Zhong; Bree R Eaton; Naba Ali; Adriana G Ioachimescu; Nelson M Oyesiku; Hui-Kuo G Shu Journal: World Neurosurg Date: 2021-12-28 Impact factor: 2.210
Authors: Renato Cozzi; Maria Rosaria Ambrosio; Roberto Attanasio; Claudia Battista; Alessandro Bozzao; Marco Caputo; Enrica Ciccarelli; Laura De Marinis; Ernesto De Menis; Marco Faustini Fustini; Franco Grimaldi; Andrea Lania; Giovanni Lasio; Francesco Logoluso; Marco Losa; Pietro Maffei; Davide Milani; Maurizio Poggi; Michele Zini; Laurence Katznelson; Anton Luger; Catalina Poiana Journal: Eur J Endocrinol Date: 2022-02-03 Impact factor: 6.664
Authors: Kerstin A Kessel; Christian D Diehl; Markus Oechsner; Bernhard Meyer; Jens Gempt; Claus Zimmer; Friederike Schmidt-Graf; Stephanie E Combs Journal: Cancers (Basel) Date: 2019-11-27 Impact factor: 6.639