Stereotactic Radiosurgery for Cushing Disease: Results of an International, Multicenter Study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023884%3A_____%2F12%3A00007389" target="_blank" >RIV/00023884:_____/12:00007389 - isvavai.cz</a>

Result on the web

<a href="http://dx.doi.org/10.1210/jc.2017-01385" target="_blank" >http://dx.doi.org/10.1210/jc.2017-01385</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1210/jc.2017-01385" target="_blank" >10.1210/jc.2017-01385</a>

Result language

angličtina

Original language name

Stereotactic Radiosurgery for Cushing Disease: Results of an International, Multicenter Study

Original language description

CONTEXT: Cushing disease (CD) due to adrenocorticotropic hormone-secreting pituitary tumors can be a management challenge. OBJECTIVE: To better understand the outcomes of stereotactic radiosurgery (SRS) for CD and define its role in management. DESIGN: International, multicenter, retrospective cohort analysis. SETTING: Ten medical centers participating in the International Gamma Knife Research Foundation. PATIENTS: Patients with CD with >6 months endocrine follow-up. INTERVENTION: SRS using Gamma Knife radiosurgery. MAIN OUTCOME MEASURES: The primary outcome was control of hypercortisolism (defined as normalization of free urinary cortisol). Radiologic response and adverse radiation effects (AREs) were recorded. RESULTS: In total, 278 patients met inclusion criteria, with a mean follow-up of 5.6 years (0.5 to 20.5 years). Twenty-two patients received SRS as a primary treatment of CD. Mean margin dose was 23.7 Gy. Cumulative initial control of hypercortisolism was 80% at 10 years. Mean time to cortisol normalization was 14.5 months. Recurrences occurred in 18% with initial cortisol normalization. Overall, the rate of durable control of hypercortisolism was 64% at 10 years and 68% among patients who received SRS as a primary treatment. AREs included hypopituitarism (25%) and cranial neuropathy (3%). Visual deficits were related to treatment of tumor within the suprasellar cistern (P = 0.01), whereas both visual (P < 0.0001) and nonvisual cranial neuropathy (P = 0.02) were related to prior pituitary irradiation. CONCLUSIONS: SRS for CD is well tolerated and frequently results in control of hypercortisolism. However, recurrences can occur. SRS should be considered for patients with persistent hypercortisolism after pituitary surgery and as a primary treatment in those unfit for surgery. Long-term endocrine follow-up is essential after SRS.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30103 - Neurosciences (including psychophysiology)

Project

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Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2017

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of Clinical Endocrinology and Metabolism

ISSN

0021-972X

e-ISSN

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Volume of the periodical

102

Issue of the periodical within the volume

11

Country of publishing house

US - UNITED STATES

Number of pages

12

Pages from-to

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UT code for WoS article

000414558500046

EID of the result in the Scopus database

2-s2.0-85031318526