Outcomes After Gamma Knife Stereotactic Radiosurgery in Pediatric Patients with Cushing Disease or Acromegaly: A Multi-Institutional Study

Pituitary adenomas comprise about 3% of all intracranial tumors in pediatric patients. This study examines the role of stereotactic radiosurgery in the management of pediatric acromegaly or patients with Cushing disease (CD). From an international consortium, we retrospectively collected treatment a...

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Bibliographic Details
Published in:World neurosurgery 2019-05, Vol.125, p.e1104-e1113
Main Authors: Shrivastava, Adesh, Mohammed, Nasser, Xu, Zhiyuan, Liščák, Roman, Kosak, Mikulas, Krsek, Michal, Karim, Khaled Abdel, Lee, Cheng-Chia, Martínez-Moreno, Nuria, Lee Vance, Mary, Lunsford, L. Dade, Sheehan, Jason P.
Format: Article
Language:English
Subjects:
Acromegaly
Acromegaly - complications
Acromegaly - diagnosis
Acromegaly - radiotherapy
Adolescent
Adult
Child
Cushing disease
Female
Gamma Knife radiosurgery
Humans
Kaplan-Meier Estimate
Male
Pituitary ACTH Hypersecretion - complications
Pituitary ACTH Hypersecretion - diagnosis
Pituitary ACTH Hypersecretion - radiotherapy
Pituitary Neoplasms - complications
Radiosurgery
Retrospective Studies
Stereotactic radiosurgery
Treatment Outcome
Young Adult
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Summary:Pituitary adenomas comprise about 3% of all intracranial tumors in pediatric patients. This study examines the role of stereotactic radiosurgery in the management of pediatric acromegaly or patients with Cushing disease (CD). From an international consortium, we retrospectively collected treatment and outcome data on pediatric adrenocorticotrophic hormone and growth hormone–secreting pituitary adenomas treated with Gamma Knife radiosurgery (GKRS). There were a total of 36 patients including 24 with CD and 12 with acromegaly. The data were analyzed to assess outcomes including tumor control, endocrine remission, and adverse effects. Statistical analysis was performed to determine correlation between clinical/treatment parameters and outcomes. At the last follow-up after GKRS, endocrine remission rates for CD and acromegaly were 80% and 42%, respectively. Tumor control was achieved in 87.5% of patients with CD and in 42% of patients with acromegaly. New pituitary hormone deficiency occurred in 7 of the 36 patients at a median time of 18 months after GKRS (range, 12–81 months). The predictive factors for endocrine remission were age
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2019.01.252