Abstract | OBJECTIVE: This study evaluates the safety and efficacy of gamma knife radiosurgery (GKRS) in patients with a growth hormone-secreting adenoma. METHODS: A retrospective review of data collected from a prospective database of GKRS patients between January 1988 and September 2006 was performed in patients with acromegaly. Successful endocrine outcome was defined as normalization of the insulin-like growth factor level. Tumor volume was also assessed. At least 18 months of follow-up was available in 95 patients who received radiosurgery during the study period. Mean endocrine follow-up was 57 months (range, 18-168 mo). RESULTS: Normal insulin-like growth factor levels were achieved in 50 patients (53%) at an average time of 29.8 months after radiosurgery (median, 23.5 mo). A decrease in tumor volume control was achieved in 83 (92%) of 90 patients. Five patients (6%) had no change in tumor volume, and two patients (2%) had an increase in tumor volume. New endocrine deficiencies developed in 32 patients (34%). Four patients developed new-onset partial visual acuity deficits; three of these patients had received previous conventional fractionated radiation therapy. CONCLUSION: GKRS is a complementary treatment for recurrent or residual growth hormone-secreting pituitary adenomas. Although infrequent, tumor growth, new-onset pituitary hormone deficiency, recurrence, and neurological dysfunction require careful clinical, radiological, and endocrinological follow-up.
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Authors | Jay Jagannathan, Jason P Sheehan, Nader Pouratian, Edward R Laws Jr, Ladislau Steiner, Mary L Vance |
Journal | Neurosurgery
(Neurosurgery)
Vol. 62
Issue 6
Pg. 1262-9; discussion 1269-70
(Jun 2008)
ISSN: 1524-4040 [Electronic] United States |
PMID | 18824992
(Publication Type: Journal Article)
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Topics |
- Acromegaly
(etiology, surgery)
- Adenoma
(pathology, surgery)
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Cohort Studies
- Female
- Growth Hormone-Secreting Pituitary Adenoma
(pathology, surgery)
- Humans
- Male
- Middle Aged
- Radiosurgery
- Reoperation
- Retrospective Studies
- Treatment Failure
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