LONG-TERM RESULTS OF STEREOTACTIC RADIOSURGERY IN SECRETORY PITUITARY ADENOMAS Export

@article{citeulike:4839063, abstract = {Context: To date, no study reported long-term follow-up results of Gamma Knife stereotactic radiosurgery (SR).Objective: To determine long-term efficacy and adverse effects of SR in secreting pituitary adenomas.Design: Retrospective study of patients treated by SR in the center of Marseille, France, with a follow-up at least equal to 60 months.Patients: 76 patients were treated by SR for acromegaly (n=43), Cushing's disease (CD, n=18) or prolactinoma (n=15), as a primary (n=27) or adjunctive post-surgical treatment (n=49).Main Outcome Measures: After withdrawal of antisecretory drugs, patients were considered in remission if they had mean GH levels < 2 ng/ml and normal IGF1 (acromegaly), normal 24h urinary free cortisol and cortisol < 50 nmol/l after low dose dexamethasone test (CD), or 2 consecutive normal samplings of prolactin levels (prolactinoma).Results: After a mean follow-up of 96 months, 44.7\% of the patients were in remission. Mean time to remission was 42.6 months. Twelve patients presented late remission at least 48 months after SR. Two patients with CD presented late recurrence 72 and 96 months after SR. Forty percent of patients treated primarily with SR were in remission. Target volume and initial hormone levels were significant predictive factors of remission in univariate analysis. Radiation-induced hypopituitarism was observed in 23\% patients; in half of them, hypopituitarism was observed after a mean time of 48 to 96 months. Twenty-four patients were followed more than 120 months: rates of remission and hypopituitarism were similar to the whole cohort.Conclusions: SR is an effective and safe primary or adjunctive treatment in selected patients with secreting pituitary adenomas. 10.1210/jc.2008-2772}, author = {Castinetti, Frederic and Nagai, Mariko and Morange, Isabelle and Dufour, Henry and Caron, Philippe and Chanson, Philippe and Cortet-Rudelli, Christine and Kuhn, Jean-Marc and Conte-Devolx, Bernard and Regis, Jean and Brue, Thierry}, citeulike-article-id = {4839063}, citeulike-linkout-0 = {http://dx.doi.org/10.1210/jc.2008-2772}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/19509108}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=19509108}, day = {9}, doi = {10.1210/jc.2008-2772}, journal = {J Clin Endocrinol Metab}, keywords = {acromegaly, adrenal, hypophysis, therapy, tumor}, month = {June}, pages = {jc.2008-2772+}, posted-at = {2009-06-13 22:35:12}, priority = {2}, title = {LONG-TERM RESULTS OF STEREOTACTIC RADIOSURGERY IN SECRETORY PITUITARY ADENOMAS}, url = {http://dx.doi.org/10.1210/jc.2008-2772}, year = {2009} }

TY - JOUR ID - citeulike:4839063 L3 - citeulike-article-id:4839063 N2 - Context: To date, no study reported long-term follow-up results of Gamma Knife stereotactic radiosurgery (SR).Objective: To determine long-term efficacy and adverse effects of SR in secreting pituitary adenomas.Design: Retrospective study of patients treated by SR in the center of Marseille, France, with a follow-up at least equal to 60 months.Patients: 76 patients were treated by SR for acromegaly (n=43), Cushing's disease (CD, n=18) or prolactinoma (n=15), as a primary (n=27) or adjunctive post-surgical treatment (n=49).Main Outcome Measures: After withdrawal of antisecretory drugs, patients were considered in remission if they had mean GH levels < 2 ng/ml and normal IGF1 (acromegaly), normal 24h urinary free cortisol and cortisol < 50 nmol/l after low dose dexamethasone test (CD), or 2 consecutive normal samplings of prolactin levels (prolactinoma).Results: After a mean follow-up of 96 months, 44.7% of the patients were in remission. Mean time to remission was 42.6 months. Twelve patients presented late remission at least 48 months after SR. Two patients with CD presented late recurrence 72 and 96 months after SR. Forty percent of patients treated primarily with SR were in remission. Target volume and initial hormone levels were significant predictive factors of remission in univariate analysis. Radiation-induced hypopituitarism was observed in 23% patients; in half of them, hypopituitarism was observed after a mean time of 48 to 96 months. Twenty-four patients were followed more than 120 months: rates of remission and hypopituitarism were similar to the whole cohort.Conclusions: SR is an effective and safe primary or adjunctive treatment in selected patients with secreting pituitary adenomas. 10.1210/jc.2008-2772 JF - J Clin Endocrinol Metab TI - LONG-TERM RESULTS OF STEREOTACTIC RADIOSURGERY IN SECRETORY PITUITARY ADENOMAS SP - jc.2008-2772 KW - acromegaly KW - adrenal KW - hypophysis KW - therapy KW - tumor AU - Castinetti, Frederic AU - Nagai, Mariko AU - Morange, Isabelle AU - Dufour, Henry AU - Caron, Philippe AU - Chanson, Philippe AU - Cortet-Rudelli, Christine AU - Kuhn, Jean-Marc AU - Conte-Devolx, Bernard AU - Regis, Jean AU - Brue, Thierry PY - 2009/06/09/ UR - http://dx.doi.org/10.1210/jc.2008-2772 ER -