Long-term results of gamma knife stereotactic radiosurgery for non-functioning pituitary adenomas

Context: To date, no study reported long-term follow-up results of gamma knife stereotactic radiosurgery (SR). Objective: The aim of the study was to determine long-term efficacy and adverse effects of SR in secreting pituitary adenomas. Design: We conducted a retrospective study of patients treated by SR in the center of Marseille, France, with a follow-up of at least 60 months. Patients: A total of 76 patients were treated by SR for acromegaly (n = 43), Cushing’s disease (CD; n = 18), or prolactinoma (n = 15) as a primary (n = 27) or adjunctive postsurgical treatment (n = 49). Main Outcome Measures: After withdrawal of antisecretory drugs, patients were considered in remission if they had mean GH levels below 2 ng/ml and normal IGF-I (acromegaly), normal 24-h urinary free cortisol, and cortisol less than 50 nmol/liter after low-dose dexamethasone test (CD) or two consecutive normal samplings of prolactin levels (prolactinoma). Results: After a mean follow-up of 96 months, 44.7% of the patients were in remission. Mean time to remission was 42.6 months. Twelve patients presented late remission at least 48 months after SR. Two patients with CD presented late recurrence 72 and 96 months after SR. Forty percent of patients treated primarily with SR were in remission. Target volume and initial hormone levels were significant predictive factors of remission in univariate analysis. Radiation-induced hypopituitarism was observed in 23% patients; in half of them, hypopituitarism was observed after a mean time of 48 to 96 months. Twenty-four patients were followed for more than 120 months; rates of remission and hypopituitarism were similar to the whole cohort. Conclusions: SR is an effective and safe primary or adjunctive treatment in selected patients with secreting pituitary adenomas. Long-term results of Gamma Knife radiosurgery draw attention to the possibility of late recurrence, late remission, and low risk of hypopituitarism.

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Stereotactic radiosurgery for pituitary adenomas: a comprehensive review of indications, techniques and long-term results using the Gamma Knife

Journal of Neuro-Oncology ◽

10.1007/s11060-009-9832-5 ◽

2009 ◽

Vol 92 (3) ◽

pp. 345-356 ◽

Cited By ~ 62

Author(s):

Jay Jagannathan ◽

Chun-Po Yen ◽

Nader Pouratian ◽

Edward R. Laws ◽

Jason P. Sheehan

Keyword(s):

Stereotactic Radiosurgery ◽

Gamma Knife ◽

Pituitary Adenomas ◽

Long Term Results ◽

Comprehensive Review

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Skull base aneurysmal bone cyst presenting with hydrocephalus: progressive residuum obliterated by Gamma Knife stereotactic radiosurgery in a pediatric patient

Journal of Neurosurgery Pediatrics ◽

10.3171/2020.2.peds19755 ◽

2020 ◽

Vol 26 (1) ◽

pp. 76-81

Author(s):

George H. Tse ◽

Feng Y. Jiang ◽

Matthias W. R. Radatz ◽

Saurabh Sinha ◽

Hesham Zaki

Keyword(s):

Skull Base ◽

Stereotactic Radiosurgery ◽

Gamma Knife ◽

Pediatric Population ◽

Bone Cyst ◽

Disease Free Survival ◽

Long Term Follow Up ◽

Aneurysmal Bone Cysts ◽

Gamma Knife Stereotactic Radiosurgery

Aneurysmal bone cysts (ABCs) are an uncommon entity predominantly encountered in the pediatric population. The skull is rarely involved, but these cysts have been reported to arise in the skull base. Traditional treatment has been with surgery alone; however, there is a gathering body of literature that reports alternative treatments that can achieve long-term disease-free survival. However, these therapies are predominantly directed at peripheral skeletal lesions. To the authors’ knowledge, this report is the first to describe long-term follow-up of the efficacy of Gamma Knife stereotactic radiosurgery for treatment of ABC residuum in the skull base that resulted in long-term patient stability and likely ABC obliteration.

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