Characteristic of Tumor Regrowth After Gamma Knife Radiosurgery and Outcomes of Repeat Gamma Knife Radiosurgery in Nonfunctioning Pituitary Adenomas

Li, Yanli; Wu, Lijuan; Quan, Tingting; Fu, Junyi; Cao, Lixue; Li, Xi; Liang, Shuli; Huang, Minyi; Deng, Yao; Yu, Jinxiu

doi:10.3389/fonc.2021.627428

Cited by 3 publications

(1 citation statement)

References 29 publications

(48 reference statements)

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“…The main purpose of delivering SRS for pituitary adenoma is to prevent tumor progression, but it shows a relatively slow response for hypersecretion of functional adenoma. The tumor growth-control rate for pituitary adenoma was around 90%–93% at 5–10 years[ 64 65 66 67 68 69 ]. A comprehensive review of the long-term outcome of a large population treated with SRS was summarized [ Table 6 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of benign brain tumors treated with single fraction LINAC-based stereotactic radiosurgery

Lin¹,

Chew²,

Chen³

et al. 2022

Tzu Chi Medical Journal

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Objectives: Accelerator-based stereotactic radiosurgery (SRS) is a noninvasive and effective treatment modality widely used for benign brain tumors. This study aims to report 20-year treatment outcomes in our institute. Materials and Methods: From May 2001 to December 2020, 127 patients treated with LINAC-based single-fraction SRS for their benign brain lesions were included. A neurosurgeon and two radiation oncologists retrospectively reviewed all data. Computed tomography (CT) simulation was performed after head-frame fixation under local anesthesia. All planning CT images were co-registered and fused with gadolinium-enhanced magnetic resonance imaging taken within 3 months for lesions targeting and critical organs delineation. The marginal dose was prescribed at 60%–90% isodose lines, respectively, to cover ≥95% planning target volume. Outcome evaluations included clinical tumor control rate (TCR), defined as the need for salvage therapy, and radiological response, defined as no enlargement of >2 cm in the maximal diameter. Overall survival (OS) and adverse reaction (defined according to CTCAE 5.0) were also analyzed. Results: The present study included 76 female and 51 male patients for analysis. The median age was 59 years (range, 20–88 years). Their diagnoses were vestibular schwannoma (VS, n = 54), nonvestibular cranial nerve schwannoma ( n = 6), meningioma ( n = 50), and pituitary adenoma ( n = 17). Totally 136 lesions were treated in a single fraction, predominantly skull base tumors, accounting for 69.1%. Median and mean follow-up duration was 49 and 61 months (range, 1–214 months), Overall TCR was 92.9%. The 5-year disease-specific TCR for VS, nonvestibular schwannoma, meningioma, and pituitary adenoma were 97.4%, 91.7%, 93.8%, and 83.3%. Salvage therapy was indicated for eight patients at 4–110 months after SRS. Among symptomatic patients, post-SRS symptom(s) was improved, stable, and worse in 68.2%, 24.3%, and 3.6%, respectively. Radiological response rate for 111 evaluable patients was 94.6% (shrinkage, 28.8%; stable, 65.8%). OS was 96.1% without treatment-related mortality. One patient with post-SRS cranial nerve injury (0.8%, involving the trigeminal nerve, grade 2 toxicities). No grade 3–4 acute or late toxicity was found. Conclusion: Our results suggested that LINAC-based SRS effectively controls tumor growth and tumor-related neurological symptoms for patients with benign brain tumors. SRS is less aggressive, associated with low neurological morbidity and no mortality. Continuous follow-up is indicated to conclude longer outcomes.

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes of benign brain tumors treated with single fraction LINAC-based stereotactic radiosurgery

Lin¹,

Chew²,

Chen³

et al. 2022

Tzu Chi Medical Journal

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Gamma knife radiosurgery for orbital cavernous hemangioma: a systematic review and single-arm meta-analysis

Punukollu,

Franklin,

Pineda

et al. 2024

J Neurooncol

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Stereotactic radiosurgery for nonfunctioning pituitary tumor: A multicenter study of new pituitary hormone deficiency

Dumot,

Mantziaris,

Dayawansa

et al. 2023

Neuro-Oncology

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Background Stereotactic radiosurgery (SRS) is used to treat recurrent or residual nonfunctioning pituitary neuroendocrine tumors (NFPA). The objective of the study was to assess imaging and development of new pituitary hormone deficiency. Methods Patients treated with single-session SRS for a NFPA were included in this retrospective, multicenter study. Tumor control and new pituitary dysfunction were evaluated using Cox analysis and Kaplan–Meier curves. Results A total of 869 patients (male 476 [54.8%], median age at SRS 52.5 years [Interquartile range (IQR): 18.9]) were treated using a median margin dose of 14Gy (IQR: 4) for a median tumor volume of 3.4 cc (IQR: 4.3). With a median radiological follow-up of 3.7 years (IQR: 4.8), volumetric tumor reduction occurred in 451 patients (51.9%), stability in 364 (41.9%) and 54 patients (6.2%) showed tumor progression. The probability of tumor control was 95.5% (95% Confidence Interval [CI]: 93.8–97.3) and 88.8% (95%CI: 85.2–92.5) at 5 and 10 years, respectively. A margin dose >14 Gy was associated with tumor control (Hazard Ratio [HR]:0.33, 95% CI: 0.18–0.60, P < 0.001). The probability of new hypopituitarism was 9.9% (95% CI: 7.3–12.5) and 15.3% (95% CI: 11–19.4) at 5 and 10 years, respectively. A maximum point dose >10 Gy in the pituitary stalk was associated with new pituitary hormone deficiency (HR: 3.47, 95% CI: 1.95–6.19). The cumulative probability of new cortisol, thyroid, gonadotroph, and growth hormone deficiency was 8% (95% CI: 3.9–11.9), 8.3% (95% CI: 3.9–12.5), 3.5% (95% CI: 1.7–5.2), and 4.7% (95% CI: 1.9–7.4), respectively at 10 years. Conclusions SRS provides long-term tumor control with a 15.3% risk of hypopituitarism at 10 years.

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Characteristic of Tumor Regrowth After Gamma Knife Radiosurgery and Outcomes of Repeat Gamma Knife Radiosurgery in Nonfunctioning Pituitary Adenomas

Cited by 3 publications

References 29 publications

Clinical outcomes of benign brain tumors treated with single fraction LINAC-based stereotactic radiosurgery

Clinical outcomes of benign brain tumors treated with single fraction LINAC-based stereotactic radiosurgery

Gamma knife radiosurgery for orbital cavernous hemangioma: a systematic review and single-arm meta-analysis

Stereotactic radiosurgery for nonfunctioning pituitary tumor: A multicenter study of new pituitary hormone deficiency

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