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

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30103 - Neurosciences (including psychophysiology)

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2017

Kód důvěrnosti údajů

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

Název periodika

Journal of Clinical Endocrinology and Metabolism

ISSN

0021-972X

e-ISSN

—

Svazek periodika

102

Číslo periodika v rámci svazku

11

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

12

Strana od-do

—

Kód UT WoS článku

000414558500046

EID výsledku v databázi Scopus

2-s2.0-85031318526