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

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00064173:_____/17:N0000113

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's Disease: Results of an International, Multicenter Study

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30202 - Endocrinology and metabolism (including diabetes, hormones)

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

The Journal of Clinical Endocrinology &amp; 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

8

Strana od-do

4284-4291

Kód UT WoS článku

000414558500046

EID výsledku v databázi Scopus

2-s2.0-85031318526