Endocrine Response after Gamma Knife-Based Stereotactic Radiosurgery for Secretory Pituitary Adenoma

Tinnel, Brent; Henderson, M.; Witt, Thomas C.; Fakiris, Achilles J.; Worth, Robert M.; Rosiers, Paul M. Des; Edmondson, James W.; Timmerman, Robert; Lo, Simon S.

doi:10.1159/000151717

Cited by 35 publications

(23 citation statements)

References 41 publications

(16 reference statements)

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“…The low rate of visual complications following SRS likely stems from each group's attempt to limit the dose received by the optic apparatus to 8-10 Gy. Moreover, Tinnel et al 55 reported new-onset cranial nerve palsies in 11% of patients, although cranial neuropathies were only observed in 3 other studies. 4,36,52 Headache, trigeminal neuralgia, temporal lobe epilepsy, brain necrosis, and carotid artery stenosis were other documented complications of SRS, although these were noted relatively infrequently across all series.…”

Section: Adverse Effectsmentioning

confidence: 98%

The role of stereotactic radiosurgery in the multimodal management of growth hormone–secreting pituitary adenomas

Stapleton

Liu

Weiss

2010

FOC

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Growth hormone (GH)–secreting pituitary adenomas represent a common source of GH excess in patients with acromegaly. Whereas surgical extirpation of the culprit lesion is considered first-line treatment, as many as 19% of patients develop recurrent symptoms due to regrowth of previously resected adenomatous tissue or to continued growth of the surgically inaccessible tumor. Although medical therapies that suppress GH production can be effective in the management of primary and recurrent acromegaly, these therapies are not curative, and lifelong treatment is required for hormonal control. Stereotactic radiosurgery has emerged as an effective adjunctive treatment modality, and is an appealing alternative to conventional fractionated radiation therapy. The authors reviewed the growing body of literature concerning the role of radiosurgical procedures in the treatment armamentarium of acromegaly, and identified more than 1350 patients across 45 case series. In this review, the authors report that radiosurgery offers true hormonal normalization in 17% to 82% of patients and tumor growth control in 37% to 100% of cases across all series, while minimizing adverse complications. As a result, stereotactic radiosurgery represents a safe and effective treatment option in the multimodal management of primary or recurrent acromegaly secondary to GH-secreting pituitary adenomas.

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Section: Adverse Effectsmentioning

confidence: 98%

The role of stereotactic radiosurgery in the multimodal management of growth hormone–secreting pituitary adenomas

Stapleton

Liu

Weiss

2010

FOC

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“…A robotic arm provides three-dimensional movement that obviates the need for rigid cranial fixation during radiation delivery (Courtesy of www.accuray.com). endocrine remission in 47-52% of patients using 50 and 30 Gy doses, respectively [120,132], most other studies reporting remission in the 20-25% range with an average follow-up approaching 60 months [93,105,129,[133][134][135].…”

Section: Growth Hormone Secretory Adenomasmentioning

confidence: 94%

Recent advances in pituitary tumor management

Winder

Mayberg²

2011

Current Opinion in Endocrinology, Diabetes and Obesity

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“…1,2,7,10,13,14,18,24,26,[29][30][31]33) Descriptions of the endocrine and radiographic outcomes of GKRS for GH-secreting adenomas are summarized in Table 2. In these studies, the mean follow-up periods ranged from 35 to 120 months.…”

Section: Gh-secreting Adenomas I Gamma Knifementioning

confidence: 99%

“…Several articles have been published about the treatment of PRL-secreting adenomas with GKRS since 2006. 1,9,13,24,27,30,33) Endocrine and radiographic outcomes of GKRS for PRL-secreting adenomas are summarized in Table 4. In these studies, mean follow-up periods ranged from 19.5 to 86.2 months.…”

Section: Prl-secreting Adenomas I Gamma Knifementioning

confidence: 99%

Stereotactic Radiosurgery/Radiotherapy for Pituitary Adenomas: A Review of Recent Literature

Kajiwara

Saitô²,

Yoshikawa

et al. 2010

Neurol. Med. Chir.(Tokyo)

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The recent clinical results are reviewed of stereotactic radiosurgery/radiotherapy for the treatment of pituitary adenomas. The outcomes of pituitary adenomas treated by stereotactic radiosurgery/radiotherapy with gamma knife, CyberKnife, or linear accelerator (LINAC) radiosurgery were evaluated from articles published after 2004. Each study was evaluated for the number of patients, radiosurgical parameter (marginal dose), length of follow up, tumor growth control, rate of hormonal normalization in secretary adenomas, and adverse events. After gamma knife radiosurgery, the tumor reduction rates varied from 42.3% to 89% in non-secreting adenomas. However, the tumor control rates in non-secreting adenomas were more than 90% in most studies. In growth hormone-secreting adenomas, the rates of insulin-like growth factor-1 normalization ranged from 36.9% to 82%. In adrenocorticotropin-secreting adenomas, the rates for 24-hour urine free cortisol normalization ranged from 27.9% to 54%. In prolactin-secreting adenomas, the prolactin normalization ranged from 17.4% to 50%. New hormonal deficits ranged from 0% to 34%. New visual deficits were relatively low. The number of patients treated with CyberKnife and LINAC radiosurgery/radiotherapy was small and follow-up periods were relatively short compared to those with gamma knife treatment, but the clinical outcomes after these therapies were similar to those after gamma knife therapy. Image-guided stereotactic radiosurgery/radiotherapy with the gamma knife, CyberKnife, or LINAC system is effective and safe against pituitary adenomas. Careful long-term follow up of the patients is necessary because of longterm anti-tumor effects and delayed adverse events.

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Endocrine Response after Gamma Knife-Based Stereotactic Radiosurgery for Secretory Pituitary Adenoma

Cited by 35 publications

References 41 publications

The role of stereotactic radiosurgery in the multimodal management of growth hormone–secreting pituitary adenomas

The role of stereotactic radiosurgery in the multimodal management of growth hormone–secreting pituitary adenomas

Recent advances in pituitary tumor management

Stereotactic Radiosurgery/Radiotherapy for Pituitary Adenomas: A Review of Recent Literature

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