The Role of Stereotactic Radiotherapy in Patients with Growth Hormone-Secreting Pituitary Adenoma Export

@article{citeulike:3689511, abstract = {Context: Single-session stereotactic radiotherapy (SR) may be a potential adjuvant treatment in acromegaly. Objective: We analyzed the safety and efficacy of SR in patients who had previously received maximal surgical debulking at our center. Design: The study was a retrospective analysis of hormonal, radiological, and ophthalmologic data collected in a predefined protocol from 1994 through 2006. Setting: The study was performed at a university hospital. Patients: Eighty-three acromegalic patients, 52 women and 31 men, with a mean age of 42.6 {+/-} 1.2 yr, participated in the study. The median follow-up was 69 months (interquartile range 44-107 months). Intervention: The patients were treated with SR for residual or recurrent GH-secreting adenoma. Main Outcome Measure: Normalization of age- and sex-adjusted IGF-I levels together with a basal GH level below 2.5 {micro}g/liter without concomitant GH-suppressive drugs was the goal of therapy. Results: Fifty patients (60.2\%) reached the main outcome of the study. The rate of remission was 52.6\% at 5 yr [95\% confidence interval (CI) 40.6-64.6\%]. Another 13 patients (15.7\%), who were resistant to somatostatin analogs, were in remission after SR. Multivariate analysis showed that low basal GH and IGF-I levels were associated with a favorable outcome. No serious side effects occurred after SR. The 5-yr cumulative risk of new onset hypogonadism, hypothyroidism, or hypoadrenalism was 3.6\% (95\% CI 0-8.6\%), 3.3\% (95\% CI 0-7.7\%), and 4.9\% (95\% CI 0-10.4\%), respectively. Conclusion: In a highly selected group of acromegalic patients, SR treatment had good efficacy and safety. This may lead to reconsider the role of SR in the therapeutic algorithm of acromegaly. 10.1210/jc.2008-0135}, author = {Losa, Marco and Gioia, Lorenzo and Picozzi, Piero and Franzin, Alberto and Valle, Micol and Giovanelli, Massimo and Mortini, Pietro}, citeulike-article-id = {3689511}, citeulike-linkout-0 = {http://dx.doi.org/10.1210/jc.2008-0135}, citeulike-linkout-1 = {http://jcem.endojournals.org/cgi/content/abstract/93/7/2546}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/18413424}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=18413424}, day = {1}, doi = {10.1210/jc.2008-0135}, journal = {J Clin Endocrinol Metab}, keywords = {acromegaly, therapy}, month = {July}, number = {7}, pages = {2546--2552}, posted-at = {2008-11-25 19:43:33}, priority = {2}, title = {The Role of Stereotactic Radiotherapy in Patients with Growth Hormone-Secreting Pituitary Adenoma}, url = {http://dx.doi.org/10.1210/jc.2008-0135}, volume = {93}, year = {2008} }

TY - JOUR ID - citeulike:3689511 L3 - citeulike-article-id:3689511 N2 - Context: Single-session stereotactic radiotherapy (SR) may be a potential adjuvant treatment in acromegaly. Objective: We analyzed the safety and efficacy of SR in patients who had previously received maximal surgical debulking at our center. Design: The study was a retrospective analysis of hormonal, radiological, and ophthalmologic data collected in a predefined protocol from 1994 through 2006. Setting: The study was performed at a university hospital. Patients: Eighty-three acromegalic patients, 52 women and 31 men, with a mean age of 42.6 {+/-} 1.2 yr, participated in the study. The median follow-up was 69 months (interquartile range 44-107 months). Intervention: The patients were treated with SR for residual or recurrent GH-secreting adenoma. Main Outcome Measure: Normalization of age- and sex-adjusted IGF-I levels together with a basal GH level below 2.5 {micro}g/liter without concomitant GH-suppressive drugs was the goal of therapy. Results: Fifty patients (60.2%) reached the main outcome of the study. The rate of remission was 52.6% at 5 yr [95% confidence interval (CI) 40.6-64.6%]. Another 13 patients (15.7%), who were resistant to somatostatin analogs, were in remission after SR. Multivariate analysis showed that low basal GH and IGF-I levels were associated with a favorable outcome. No serious side effects occurred after SR. The 5-yr cumulative risk of new onset hypogonadism, hypothyroidism, or hypoadrenalism was 3.6% (95% CI 0-8.6%), 3.3% (95% CI 0-7.7%), and 4.9% (95% CI 0-10.4%), respectively. Conclusion: In a highly selected group of acromegalic patients, SR treatment had good efficacy and safety. This may lead to reconsider the role of SR in the therapeutic algorithm of acromegaly. 10.1210/jc.2008-0135 IS - 7 JF - J Clin Endocrinol Metab EP - 2552 TI - The Role of Stereotactic Radiotherapy in Patients with Growth Hormone-Secreting Pituitary Adenoma VL - 93 SP - 2546 KW - acromegaly KW - therapy AU - Losa, Marco AU - Gioia, Lorenzo AU - Picozzi, Piero AU - Franzin, Alberto AU - Valle, Micol AU - Giovanelli, Massimo AU - Mortini, Pietro PY - 2008/07/01/ UR - http://dx.doi.org/10.1210/jc.2008-0135 ER -