Acta neurochirurgica · 2024
Long-term tumor control following gamma-knife radiosurgery of recurrent or residual pituitary adenomas: a population-based cohort study.
СтатьяНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Gabri Alexander, Lindberg Felicia, Kristiansson Helena, Gubanski Michael, Höybye Charlotte, Olsson Martin, Förander Petter, Skyrman Simon, Lippitz Bodo, Fletcher-Sandersjöö Alexander, Bartek Jiri
Аннотация
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.
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.