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

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F17%3A43915592" target="_blank" >RIV/00216208:11120/17:43915592 - isvavai.cz</a>

Alternative codes found

RIV/00064173:_____/17:N0000113

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's Disease: Results of an International, Multicenter Study

Original language description

Context: Cushing&apos;s disease (CD) due to ACTH-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 (IGKRF). Patients: Patients with CD with greater than 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 were recorded. Results: 278 patients met inclusion criteria, with mean follow-up of 5.6 years (0.5-20.5 years). Twenty-two patients received SRS as a primary treatment for 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. Adverse radiation effects included hypopituitarism (25%) and cranial neuropathy (3%). Visual deficits were related to treatment of tumor within the suprasellar cistern (P=0.01), while both visual (P&lt;0.0001) and non-visual 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

30202 - Endocrinology and metabolism (including diabetes, hormones)

Project

—

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

The Journal of Clinical Endocrinology &amp; Metabolism

ISSN

0021-972X

e-ISSN

—

Volume of the periodical

102

Issue of the periodical within the volume

11

Country of publishing house

US - UNITED STATES

Number of pages

8

Pages from-to

4284-4291

UT code for WoS article

000414558500046

EID of the result in the Scopus database

2-s2.0-85031318526