放射外科治疗肢端肥大症的有效性和安全性。

IF 6.1 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
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引用次数: 0

摘要

立体定向放射外科(SRS)在渐冻人症的治疗中发挥着越来越重要的作用。我们根据PRISMA对SRS治疗分泌生长激素(GH)的垂体腺瘤的文献进行了系统性回顾和荟萃分析,包括几种放射外科技术,目的是描述这种治疗方法的有效性和安全性。该研究采用加权随机效应模型计算汇总结果估计值。从346篇摘要综述中,共纳入了27篇回顾性研究。尽管荷尔蒙缓解标准存在差异,纳入研究的治疗指南之间也存在异质性,但大多数研究报告的内分泌缓解率在40%至60%之间。随机效应荟萃分析显示,总体内分泌缓解率和SRS后5年缓解概率估计值分别为46%(95% CI:39-53%)和48%(95% CI:38-57%)。随机效应荟萃分析显示,SRS术后新发垂体功能减退症的概率为23%(95% CI:17-29%)。此外,SRS 后辐射诱发视神经病变的发生率介于 0% 和 6% 之间。这项荟萃分析证实并量化了 SRS 在肢端肥大症手术治疗后实现内分泌缓解的安全性和有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy and safety of radiosurgery in acromegaly

Stereotactic radiosurgery (SRS) more and more frequently plays a crucial role in the treatment of acromegaly. We provide a systematic review of the literature and meta-analysis, according to PRISMA, on SRS for the management of growth hormone (GH)-secreting pituitary adenomas, including several radiosurgical techniques, with the aim of describing efficacy and safety of this treatment. A weighted random effects model was used to calculate pooled outcome estimates. From 346 abstract reviews, 27 retrospective studies were included. Despite the variability in hormonal remission criteria and the heterogeneity between treatment guidelines among included studies, most of them reported an endocrine remission rate between 40% and 60%. Random effects meta-analysis for overall endocrine remission and 5-year probability of remission estimate after SRS were 46% (95% CI: 39–53%) and of 48% (95% CI: 38–57%), respectively. Random effects meta-analysis for new hypopituitarism estimate after SRS was 23% (95% CI: 17–29%). Furthermore, incidence of radiation induced optic neuropathy after SRS ranged between 0% and 6% This meta-analysis confirms and quantifies safety and effectiveness of SRS to achieve endocrine remission after surgical management in acromegaly.

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来源期刊
CiteScore
11.90
自引率
0.00%
发文量
77
审稿时长
6-12 weeks
期刊介绍: Best Practice & Research Clinical Endocrinology & Metabolism is a serial publication that integrates the latest original research findings into evidence-based review articles. These articles aim to address key clinical issues related to diagnosis, treatment, and patient management. Each issue adopts a problem-oriented approach, focusing on key questions and clearly outlining what is known while identifying areas for future research. Practical management strategies are described to facilitate application to individual patients. The series targets physicians in practice or training.
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