TY - JOUR
T1 - Long-term tumor control following gamma-knife radiosurgery of recurrent or residual pituitary adenomas
T2 - a population-based cohort study
AU - Gabri, Alexander
AU - Lindberg, Felicia
AU - Kristiansson, Helena
AU - Gubanski, Michael
AU - Höybye, Charlotte
AU - Olsson, Martin
AU - Förander, Petter
AU - Skyrman, Simon
AU - Lippitz, Bodo
AU - Fletcher-Sandersjöö, Alexander
AU - Bartek, Jiri
N1 - © 2024. The Author(s).
PY - 2024/11/30
Y1 - 2024/11/30
N2 - BACKGROUND: Pituitary adenomas (PAs) often require adjuvant Gamma Knife radiosurgery (GKRS) due to partial resection or postoperative recurrence. The purpose of this study was to evaluate the long-term efficacy of GKRS for such cases.METHODS: Population-based, observational cohort study of patients who underwent GKRS for postoperative residual or recurrent PAs between 1999 and 2020. We assessed long-term progression-free survival (PFS), identified predictors of tumor growth, and documented adverse radiation events (AREs).RESULTS: 147 patients were included, with a median follow-up time of 8.1 years. Following GKRS, the 5-year and 10-year PFS was 86% and 68%, respectively, with a median PFS of 18.7 years. Somatotrophic adenomas showed a significantly lower risk of tumor progression in the regression analysis (OR 0.11, p = 0.003). Hypopituitarism was the most common ARE, affecting 32% of patients.CONCLUSION: GKRS is an effective treatment option for recurrent or residual PAs, offering substantial long-term control. However, the risk for AREs, particularly hypopituitarism, is not negligeable.
AB - BACKGROUND: Pituitary adenomas (PAs) often require adjuvant Gamma Knife radiosurgery (GKRS) due to partial resection or postoperative recurrence. The purpose of this study was to evaluate the long-term efficacy of GKRS for such cases.METHODS: Population-based, observational cohort study of patients who underwent GKRS for postoperative residual or recurrent PAs between 1999 and 2020. We assessed long-term progression-free survival (PFS), identified predictors of tumor growth, and documented adverse radiation events (AREs).RESULTS: 147 patients were included, with a median follow-up time of 8.1 years. Following GKRS, the 5-year and 10-year PFS was 86% and 68%, respectively, with a median PFS of 18.7 years. Somatotrophic adenomas showed a significantly lower risk of tumor progression in the regression analysis (OR 0.11, p = 0.003). Hypopituitarism was the most common ARE, affecting 32% of patients.CONCLUSION: GKRS is an effective treatment option for recurrent or residual PAs, offering substantial long-term control. However, the risk for AREs, particularly hypopituitarism, is not negligeable.
KW - Humans
KW - Radiosurgery/methods
KW - Pituitary Neoplasms/surgery
KW - Female
KW - Male
KW - Middle Aged
KW - Neoplasm Recurrence, Local/surgery
KW - Adenoma/surgery
KW - Adult
KW - Aged
KW - Cohort Studies
KW - Neoplasm, Residual/radiotherapy
KW - Treatment Outcome
KW - Follow-Up Studies
KW - Young Adult
KW - Aged, 80 and over
UR - https://www.scopus.com/pages/publications/85211177148
U2 - 10.1007/s00701-024-06380-9
DO - 10.1007/s00701-024-06380-9
M3 - Journal article
C2 - 39613987
SN - 0001-6268
VL - 166
SP - 488
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 1
M1 - 488
ER -