Repeat stereotactic radiosurgery for Cushing's disease: outcomes of an international, multicenter study

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F18%3A43916344" target="_blank" >RIV/00216208:11120/18:43916344 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064173:_____/18:N0000027 RIV/00023884:_____/18:00007851

Výsledek na webu

<a href="https://doi.org/10.1007/s11060-018-2817-5" target="_blank" >https://doi.org/10.1007/s11060-018-2817-5</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s11060-018-2817-5" target="_blank" >10.1007/s11060-018-2817-5</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Repeat stereotactic radiosurgery for Cushing's disease: outcomes of an international, multicenter study

Popis výsledku v původním jazyce

Stereotactic radiosurgery (SRS) is frequently used for Cushing&apos;s disease (CD) after failed pituitary surgery. Management of patients with persistent CD after failed SRS is complex, as the alternative therapeutic options harbor significant risks. The outcomes of repeat pituitary radiosurgery, however, have not been described. We sought to determine the outcomes of repeat SRS in patients with CD. We pooled data from five institutions participating in the International Gamma Knife Research Foundation for patients with recurrent or persistent CD GREATER-THAN OR EQUAL TO 12 months after initial SRS. Patients were included in the study if they had GREATER-THAN OR EQUAL TO 6 months endocrine follow-up after repeat SRS. Twenty patients were included in the study. Repeat single-session SRS was performed 1.3-9.7 years after initial SRS. Median endocrine follow-up was 6.6 years (1.4-19.1 years). Median margin dose was 20 Gy (range 10.8-35 Gy). Endocrine remission after second SRS was noted in 12 patients (60%), with a median time to remission of 6 months (range 2-64 months). Biochemical recurrence occurred in two patients (17%) after initial remission. Overall, the cumulative rates of durable endocrine remission at 5 and 10 years were 47 and 53%, respectively. Two patients (10%) experienced adverse radiation effects, including transient visual loss and permanent diplopia. Repeat SRS achieves lasting biochemical remission in approximately half of patients with CD refractory to both prior microsurgery and SRS. Because of the morbidity of refractory or recurrent CD, repeat SRS should be considered for carefully selected patients with hypercortisolism confirmed one or more years after initial SRS.

Název v anglickém jazyce

Repeat stereotactic radiosurgery for Cushing's disease: outcomes of an international, multicenter study

Popis výsledku anglicky

Stereotactic radiosurgery (SRS) is frequently used for Cushing&apos;s disease (CD) after failed pituitary surgery. Management of patients with persistent CD after failed SRS is complex, as the alternative therapeutic options harbor significant risks. The outcomes of repeat pituitary radiosurgery, however, have not been described. We sought to determine the outcomes of repeat SRS in patients with CD. We pooled data from five institutions participating in the International Gamma Knife Research Foundation for patients with recurrent or persistent CD GREATER-THAN OR EQUAL TO 12 months after initial SRS. Patients were included in the study if they had GREATER-THAN OR EQUAL TO 6 months endocrine follow-up after repeat SRS. Twenty patients were included in the study. Repeat single-session SRS was performed 1.3-9.7 years after initial SRS. Median endocrine follow-up was 6.6 years (1.4-19.1 years). Median margin dose was 20 Gy (range 10.8-35 Gy). Endocrine remission after second SRS was noted in 12 patients (60%), with a median time to remission of 6 months (range 2-64 months). Biochemical recurrence occurred in two patients (17%) after initial remission. Overall, the cumulative rates of durable endocrine remission at 5 and 10 years were 47 and 53%, respectively. Two patients (10%) experienced adverse radiation effects, including transient visual loss and permanent diplopia. Repeat SRS achieves lasting biochemical remission in approximately half of patients with CD refractory to both prior microsurgery and SRS. Because of the morbidity of refractory or recurrent CD, repeat SRS should be considered for carefully selected patients with hypercortisolism confirmed one or more years after initial 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

2018

Kód důvěrnosti údajů

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

Název periodika

Journal of Neuro-Oncology

ISSN

0167-594X

e-ISSN

—

Svazek periodika

138

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

7

Strana od-do

519-525

Kód UT WoS článku

000435363100008

EID výsledku v databázi Scopus

2-s2.0-85048547274