反复伽玛刀放射治疗生长中的垂体腺瘤后的长期肿瘤控制：一项基于人群的队列研究

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2024-12-06 DOI:10.1007/s00701-024-06341-2

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

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引用次数: 0

摘要

背景伽玛刀放射手术（GKRS）是部分切除后残留或生长的垂体腺瘤（PAs）的一种公认的治疗方法。然而，一些PAs即使在初始GKRS后也会生长，因此重复GKRS的疗效尚不清楚。本研究的主要目的是确定PA患者重复GKRS后的长期无进展生存期（PFS）。次要目的是确定这些患者肿瘤进展的预测因素。方法：对瑞典斯德哥尔摩卡罗林斯卡大学医院神经外科1999年至2022年间因肿瘤进展而接受重复GKRS治疗的复发性PAs患者进行单中心、基于人群的连续队列研究。评估PFS和肿瘤生长预测因子。结果纳入23例患者，中位随访时间6.3年。5年PFS率为57%，从重复GKRS到肿瘤进展的中位持续时间为2.6年。重复GKRS后的肿瘤生长仅发生在治疗后的前三年。重复GKRS时年龄较大是肿瘤持续生长的重要预测因子（OR 1.09, p = 0.036）。结论对于初始GKRS后出现生长的PAs，重复GKRS是一种可行的治疗方案。

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Long-term tumor control following repeat gamma-knife radiosurgery of growing pituitary adenomas: a population-based cohort study

Background

Gamma Knife radiosurgery (GKRS) is a well-established treatment for residual or growing pituitary adenomas (PAs) post-partial resection. However, some PAs grow even after initial GKRS, for which the efficacy of repeat GKRS is unclear. The primary objective of this study was to determine long-term progression-free survival (PFS) following repeated GKRS in patients with PA. The secondary objective was to determine predictors of tumor progression in these patients.

Methods

Single-center, population-based consecutive cohort study of patients with recurrent PAs treated with repeated GKRS due to tumor progression between 1999 and 2022 at the Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden. PFS and predictors of tumor growth were assessed.

Results

23 patients were included, with a median follow-up time of 6.3 years. The 5-year PFS rate was 57%, and the median duration from repeat GKRS to tumor progression was 2.6 years. Tumor growth after repeat GKRS occurred exclusively within the first three years post-treatment. Older age at the time of repeat GKRS was a significant predictor of continued tumor growth (OR 1.09, p = 0.036).

Conclusion

Repeat GKRS is a feasible treatment alternative for PAs that exhibit growth following initial GKRS.

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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.