Editorial: Cushing's disease and stereotactic radiosurgery

2013 ◽  
Vol 119 (6) ◽  
pp. 1484-1485 ◽  
Author(s):  
Douglas Kondziolka
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cushing’S Disease ◽  
Cushing's Disease

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

2018 ◽  
Vol 79 (S 01) ◽  
pp. S1-S188
Author(s):  
Gautam Mehta ◽  
Dale Ding ◽  
Mohana Patibandla ◽  
Hideyuki Kano ◽  
Nathaniel Sisterson ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Multicenter Study ◽  
Cushing’S Disease ◽  
Cushing's Disease ◽  
International Multicenter Study ◽  
International Multicenter

Application of stereotactic radiosurgery and radiotherapy in the treatment of Itsenko — Cushing’s disease

2020 ◽  
pp. 57-65
Author(s):  
А. Abdali ◽  
L. I. Astafieva ◽  
Yu. Yu. Trunin ◽  
A. V. Golanov ◽  
P. L. Kalinin ◽  
...  
Keyword(s):  
Literature Review ◽  
Stereotactic Radiosurgery ◽  
Cushing’S Disease ◽  
Pituitary Tumor ◽  
Initial Treatment ◽  
Adrenocorticotropic Hormone ◽  
Surgical Intervention ◽  
Radiation Treatment ◽  
Cushing's Disease ◽  
Modern Methods

Cushing’s disease is caused by a pituitary tumor which causes increased production of adrenocorticotropic hormone, leading to chronic hypersecretion of cortisol by the adrenal cortices. Endoscopic transnasal adenomectomy is the initial treatment of choice with the greatest efficiency for the treatment of the disease. However in the absence of remission or relapse of hypercortisolism after neurosurgical surgery, as well as in cases when surgical intervention cannot be carried due to medical contraindications to surgical intervention, radiation treatment is used as an alternative or adjoining therapy. In this literature review the efficiency of different radiation techniques (the conventional and the modern techniques), as well as possible complications of modern methods of radiosurgery and radiotherapy have been looked for.

Outcomes of stereotactic radiosurgery and hypofractionated stereotactic radiotherapy for refractory Cushing’s disease

Pituitary ◽  
2019 ◽  
Vol 22 (6) ◽  
pp. 607-613 ◽  
Author(s):  
Alexander D. Sherry ◽  
Mohamed H. Khattab ◽  
Mark C. Xu ◽  
Patrick Kelly ◽  
Joshua L. Anderson ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cushing’S Disease ◽  
Stereotactic Radiotherapy ◽  
Cushing's Disease ◽  
Hypofractionated Stereotactic Radiotherapy

Effect of stereotactic radiosurgery before bilateral adrenalectomy for Cushing's disease on the incidence of Nelson's syndrome

2013 ◽  
Vol 119 (6) ◽  
pp. 1493-1497 ◽  
Author(s):  
Gautam U. Mehta ◽  
Jason P. Sheehan ◽  
Mary Lee Vance
Keyword(s):  
Tumor Growth ◽  
Tumor Progression ◽  
Stereotactic Radiosurgery ◽  
Cushing’S Disease ◽  
Pituitary Tumor ◽  
Bilateral Adrenalectomy ◽  
Cushing's Disease ◽  
Cranial Neuropathy ◽  
Nelson’S Syndrome ◽  
Nelson's Syndrome

Object Nelson's syndrome (NS) is a significant and frequent risk for patients with Cushing's disease (CD) who undergo bilateral adrenalectomy. A recent study has shown tumor progression in 47% of patients at risk for NS. The authors sought to define the rate of NS in patients who were treated with Gamma Knife stereotactic radiosurgery (GK SRS) prior to bilateral adrenalectomy. Methods Consecutive patients with CD who were treated with GK SRS after pituitary surgery but before bilateral adrenalectomy were included. Serial MRI sequences were analyzed to evaluate for pituitary tumor growth. Clinical evaluations were performed to screen for NS. Follow-up for adrenocorticotropic hormone levels and hormone studies of other pituitary axes was performed. Results Twenty consecutive patients were followed with neuroimaging and clinically for a median of 5.4 years (range 0.6–12 years). One patient (5%) developed pituitary tumor growth consistent with NS 9 months after adrenalectomy. By Kaplan-Meier analysis, progression-free survival was 94.7% at 1, 3, and 7 years. No predisposing factors were identified for the tumor progression. Two patients developed new pituitary dysfunction and no patient developed cranial neuropathy or visual deficit after GK SRS. Conclusions These findings suggest that GK SRS not only serves a role as second-line therapy for CD, but that it also provides prophylaxis for NS when used before bilateral adrenalectomy.

scholarly journals Gamma knife radiosurgery is a successful adjunctive treatment in Cushing’s disease

2007 ◽  
Vol 156 (1) ◽  
pp. 91-98 ◽  
Author(s):  
F Castinetti ◽  
M Nagai ◽  
H Dufour ◽  
J-M Kuhn ◽  
I Morange ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Stereotactic Radiosurgery ◽  
Gamma Knife ◽  
Cushing’S Disease ◽  
Gamma Knife Radiosurgery ◽  
Disease Recurrence ◽  
Cushing's Disease ◽  
Adjunctive Treatment ◽  
Significant Difference

Objective: Though transsphenoidal surgery remains the first-line treatment of Cushing’s disease, recurrence occurs frequently. Conventional radiotherapy and anticortisolic drugs both have adverse effects. Stereotactic radiosurgery needs to be evaluated more precisely. The aim of this study was to determine long-term hormonal effects and tolerance of gamma knife (GK) radiosurgery in Cushing’s disease. Design: Forty patients with Cushing’s disease treated by GK were prospectively studied over a decade, with a mean follow-up of 54.7 months. Eleven of them were treated with GK as a primary treatment. Methods: Radiosurgery was performed at the Department of Functional Neurosurgery of Marseille, France, using the Leksell Gamma Unit B and C models. Median margin dose was 29.5 Gy. Patients were considered in remission if they had normalized 24-h free urinary cortisol and suppression of plasma cortisol after low-dose dexamethasone suppression test. Results: Seventeen patients (42.5%) were in remission after a mean of 22 months (range 12–48 months). The two groups did not differ in terms of initial hormonal levels. Target volume was significantly higher in uncured than in remission group (909.8 vs 443 mm3, P = 0.038). We found a significant difference between patients who were on or off anticortisolic drugs at the time of GK (20 vs 48% patients in remission respectively, P = 0.02). Conclusion: With 42% of patients in remission after a median follow-up of 54 months, GK stereotactic radiosurgery, especially as an adjunctive treatment to surgery, may represent an alternative to other therapeutic options in view of their adverse effects.

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