Long-term tumor control following gamma-knife radiosurgery of recurrent or residual pituitary adenomas: a population-based cohort study

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2024-11-30 DOI:10.1007/s00701-024-06380-9

Alexander Gabri, Felicia Lindberg, Helena Kristiansson, Michael Gubanski, Charlotte Höybye, Martin Olsson, Petter Förander, Simon Skyrman, Bodo Lippitz, Alexander Fletcher-Sandersjöö, Jiri Bartek

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Abstract

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.

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来源期刊

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.