Loading…
Gamma knife radiosurgery for acromegaly - long-term experience
Summary Objective The Leksell gamma knife (LGK) is one of the treatment options for pituitary adenomas. We report on our long‐term experience treating acromegaly using LGK. Design Since 1993 we have followed 96 acromegaly patients through periods of from 12 to 120 months. The mean follow‐up perio...
Saved in:
| Published in: | Clinical endocrinology (Oxford) 2006-05, Vol.64 (5), p.588-595 |
|---|---|
| Main Authors: | , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c5283-14502d9338e6011a1cc44c42eb73c49f03086f9b697e4e770fb73e3ec2ce419d3 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c5283-14502d9338e6011a1cc44c42eb73c49f03086f9b697e4e770fb73e3ec2ce419d3 |
| container_end_page | 595 |
| container_issue | 5 |
| container_start_page | 588 |
| container_title | Clinical endocrinology (Oxford) |
| container_volume | 64 |
| creator | Ježková, Jana Marek, Josef Hána, Václav Kršek, Michal Weiss, Vladimír Vladyka, Vilibald Lišák, Roman Vymazal, Josef Pecen, Ladislav |
| description | Summary
Objective The Leksell gamma knife (LGK) is one of the treatment options for pituitary adenomas. We report on our long‐term experience treating acromegaly using LGK.
Design Since 1993 we have followed 96 acromegaly patients through periods of from 12 to 120 months. The mean follow‐up period was 53·7 ± 26·8 months. Seventy‐two patients were treated with neurosurgery prior to LGK; for 24 LGK was the primary treatment. Thirteen patients were irradiated twice, due to persistent activity of the adenoma or its residue. Pituitary functions were tested at 6‐month intervals, post‐irradiation. The target tumour volume for radiosurgery was between 93·3 and 12 700 mm3 (median 1350 mm3).
Results Fifty per cent of the patients achieved mean GH |
| doi_str_mv | 10.1111/j.1365-2265.2006.02513.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67928705</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1058387641</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5283-14502d9338e6011a1cc44c42eb73c49f03086f9b697e4e770fb73e3ec2ce419d3</originalsourceid><addsrcrecordid>eNqNkE1rGzEQhkVJaNy0f6EsheS225G0-jq0EEziFkIKpU3BFyHLs2ad_XAkL7H_fbW1SaCn6CIx87zD6CEko1DQdD6vC8qlyBmTomAAsgAmKC92b8jkuXFCJsABcpCyPCPvYlwDgNCg3pIzmmrGaDohX2eubV320NUVZsEt6z4OYYVhn1V9yJwPfYsr1-yzPGv6bpVvMbQZ7jYYauw8vienlWsifjje5-T3zfWv6bf89sfs-_TqNveCaZ7TUgBbGs41SqDUUe_L0pcMF4r70lRpUS0rs5BGYYlKQZUayNEzjyU1S35OLg9zN6F_HDBubVtHj03jOuyHaKUyTCsQCfz0H7juh9Cl3Sw1WlNhOEuQPkDpezEGrOwm1K0Le0vBjoLt2o4e7ejRjoLtP8F2l6Ifj_OHRYvLl-DRaAIujoCL3jVVcJ2v4wunpBGa6sR9OXBPdYP7Vy9gp9d34yvl80O-jlvcPeddeEgyuBL2z93Mqp_38_n8XljJ_wIU96OW</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>198815932</pqid></control><display><type>article</type><title>Gamma knife radiosurgery for acromegaly - long-term experience</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Ježková, Jana ; Marek, Josef ; Hána, Václav ; Kršek, Michal ; Weiss, Vladimír ; Vladyka, Vilibald ; Lišák, Roman ; Vymazal, Josef ; Pecen, Ladislav</creator><creatorcontrib>Ježková, Jana ; Marek, Josef ; Hána, Václav ; Kršek, Michal ; Weiss, Vladimír ; Vladyka, Vilibald ; Lišák, Roman ; Vymazal, Josef ; Pecen, Ladislav</creatorcontrib><description>Summary
Objective The Leksell gamma knife (LGK) is one of the treatment options for pituitary adenomas. We report on our long‐term experience treating acromegaly using LGK.
Design Since 1993 we have followed 96 acromegaly patients through periods of from 12 to 120 months. The mean follow‐up period was 53·7 ± 26·8 months. Seventy‐two patients were treated with neurosurgery prior to LGK; for 24 LGK was the primary treatment. Thirteen patients were irradiated twice, due to persistent activity of the adenoma or its residue. Pituitary functions were tested at 6‐month intervals, post‐irradiation. The target tumour volume for radiosurgery was between 93·3 and 12 700 mm3 (median 1350 mm3).
Results Fifty per cent of the patients achieved mean GH < 2·5 µg/l within 42 months, normalized their IGF‐I within 54 months, and achieved GH suppression in the oral glucose tolerance test (oGTT) < 1 µg/l with normal IGF‐I within 66 months. LGK effectiveness was dependent on initial adenoma hormonal activity (GH and IGF‐I serum levels), not on the size of the adenoma. Patients with primary neurosurgery followed by LGK irradiation had better outcomes than those with LGK alone. Irradiation arrested all adenoma growth, causing tumour shrinkage in 62·3% of patients. Twenty‐six developed hypopituitarism when irradiated by 15 Gy (or more) on functional peritumoral pituitary tissue. No hypopituitarism appeared using lower doses.
Conclusions In acromegaly, LGK is a useful adjunct to primary neurosurgery when treating post‐surgical residues because it can limit the duration of medical therapy. It can be used as a primary therapy when neurosurgery is not possible.</description><identifier>ISSN: 0300-0664</identifier><identifier>EISSN: 1365-2265</identifier><identifier>DOI: 10.1111/j.1365-2265.2006.02513.x</identifier><identifier>PMID: 16649981</identifier><identifier>CODEN: CLECAP</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Acromegaly - blood ; Acromegaly - etiology ; Acromegaly - surgery ; Adenoma - blood ; Adenoma - complications ; Adenoma - surgery ; Adolescent ; Adult ; Aged ; Biological and medical sciences ; Blood Glucose - analysis ; Combined Modality Therapy ; Endocrinopathies ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Growth Hormone - blood ; Humans ; Hypothalamus. Hypophysis. Epiphysis (diseases) ; Insulin-Like Growth Factor I - analysis ; Male ; Medical sciences ; Middle Aged ; Neurosurgical Procedures ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Pituitary Neoplasms - blood ; Pituitary Neoplasms - complications ; Pituitary Neoplasms - surgery ; Radiosurgery - instrumentation ; Statistics, Nonparametric ; Treatment Outcome ; Vertebrates: endocrinology</subject><ispartof>Clinical endocrinology (Oxford), 2006-05, Vol.64 (5), p.588-595</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright Blackwell Publishing May 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5283-14502d9338e6011a1cc44c42eb73c49f03086f9b697e4e770fb73e3ec2ce419d3</citedby><cites>FETCH-LOGICAL-c5283-14502d9338e6011a1cc44c42eb73c49f03086f9b697e4e770fb73e3ec2ce419d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17695818$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16649981$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ježková, Jana</creatorcontrib><creatorcontrib>Marek, Josef</creatorcontrib><creatorcontrib>Hána, Václav</creatorcontrib><creatorcontrib>Kršek, Michal</creatorcontrib><creatorcontrib>Weiss, Vladimír</creatorcontrib><creatorcontrib>Vladyka, Vilibald</creatorcontrib><creatorcontrib>Lišák, Roman</creatorcontrib><creatorcontrib>Vymazal, Josef</creatorcontrib><creatorcontrib>Pecen, Ladislav</creatorcontrib><title>Gamma knife radiosurgery for acromegaly - long-term experience</title><title>Clinical endocrinology (Oxford)</title><addtitle>Clin Endocrinol (Oxf)</addtitle><description>Summary
Objective The Leksell gamma knife (LGK) is one of the treatment options for pituitary adenomas. We report on our long‐term experience treating acromegaly using LGK.
Design Since 1993 we have followed 96 acromegaly patients through periods of from 12 to 120 months. The mean follow‐up period was 53·7 ± 26·8 months. Seventy‐two patients were treated with neurosurgery prior to LGK; for 24 LGK was the primary treatment. Thirteen patients were irradiated twice, due to persistent activity of the adenoma or its residue. Pituitary functions were tested at 6‐month intervals, post‐irradiation. The target tumour volume for radiosurgery was between 93·3 and 12 700 mm3 (median 1350 mm3).
Results Fifty per cent of the patients achieved mean GH < 2·5 µg/l within 42 months, normalized their IGF‐I within 54 months, and achieved GH suppression in the oral glucose tolerance test (oGTT) < 1 µg/l with normal IGF‐I within 66 months. LGK effectiveness was dependent on initial adenoma hormonal activity (GH and IGF‐I serum levels), not on the size of the adenoma. Patients with primary neurosurgery followed by LGK irradiation had better outcomes than those with LGK alone. Irradiation arrested all adenoma growth, causing tumour shrinkage in 62·3% of patients. Twenty‐six developed hypopituitarism when irradiated by 15 Gy (or more) on functional peritumoral pituitary tissue. No hypopituitarism appeared using lower doses.
Conclusions In acromegaly, LGK is a useful adjunct to primary neurosurgery when treating post‐surgical residues because it can limit the duration of medical therapy. It can be used as a primary therapy when neurosurgery is not possible.</description><subject>Acromegaly - blood</subject><subject>Acromegaly - etiology</subject><subject>Acromegaly - surgery</subject><subject>Adenoma - blood</subject><subject>Adenoma - complications</subject><subject>Adenoma - surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - analysis</subject><subject>Combined Modality Therapy</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Growth Hormone - blood</subject><subject>Humans</subject><subject>Hypothalamus. Hypophysis. Epiphysis (diseases)</subject><subject>Insulin-Like Growth Factor I - analysis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurosurgical Procedures</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><subject>Pituitary Neoplasms - blood</subject><subject>Pituitary Neoplasms - complications</subject><subject>Pituitary Neoplasms - surgery</subject><subject>Radiosurgery - instrumentation</subject><subject>Statistics, Nonparametric</subject><subject>Treatment Outcome</subject><subject>Vertebrates: endocrinology</subject><issn>0300-0664</issn><issn>1365-2265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><recordid>eNqNkE1rGzEQhkVJaNy0f6EsheS225G0-jq0EEziFkIKpU3BFyHLs2ad_XAkL7H_fbW1SaCn6CIx87zD6CEko1DQdD6vC8qlyBmTomAAsgAmKC92b8jkuXFCJsABcpCyPCPvYlwDgNCg3pIzmmrGaDohX2eubV320NUVZsEt6z4OYYVhn1V9yJwPfYsr1-yzPGv6bpVvMbQZ7jYYauw8vienlWsifjje5-T3zfWv6bf89sfs-_TqNveCaZ7TUgBbGs41SqDUUe_L0pcMF4r70lRpUS0rs5BGYYlKQZUayNEzjyU1S35OLg9zN6F_HDBubVtHj03jOuyHaKUyTCsQCfz0H7juh9Cl3Sw1WlNhOEuQPkDpezEGrOwm1K0Le0vBjoLt2o4e7ejRjoLtP8F2l6Ifj_OHRYvLl-DRaAIujoCL3jVVcJ2v4wunpBGa6sR9OXBPdYP7Vy9gp9d34yvl80O-jlvcPeddeEgyuBL2z93Mqp_38_n8XljJ_wIU96OW</recordid><startdate>200605</startdate><enddate>200605</enddate><creator>Ježková, Jana</creator><creator>Marek, Josef</creator><creator>Hána, Václav</creator><creator>Kršek, Michal</creator><creator>Weiss, Vladimír</creator><creator>Vladyka, Vilibald</creator><creator>Lišák, Roman</creator><creator>Vymazal, Josef</creator><creator>Pecen, Ladislav</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>200605</creationdate><title>Gamma knife radiosurgery for acromegaly - long-term experience</title><author>Ježková, Jana ; Marek, Josef ; Hána, Václav ; Kršek, Michal ; Weiss, Vladimír ; Vladyka, Vilibald ; Lišák, Roman ; Vymazal, Josef ; Pecen, Ladislav</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5283-14502d9338e6011a1cc44c42eb73c49f03086f9b697e4e770fb73e3ec2ce419d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Acromegaly - blood</topic><topic>Acromegaly - etiology</topic><topic>Acromegaly - surgery</topic><topic>Adenoma - blood</topic><topic>Adenoma - complications</topic><topic>Adenoma - surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - analysis</topic><topic>Combined Modality Therapy</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Growth Hormone - blood</topic><topic>Humans</topic><topic>Hypothalamus. Hypophysis. Epiphysis (diseases)</topic><topic>Insulin-Like Growth Factor I - analysis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurosurgical Procedures</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><topic>Pituitary Neoplasms - blood</topic><topic>Pituitary Neoplasms - complications</topic><topic>Pituitary Neoplasms - surgery</topic><topic>Radiosurgery - instrumentation</topic><topic>Statistics, Nonparametric</topic><topic>Treatment Outcome</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ježková, Jana</creatorcontrib><creatorcontrib>Marek, Josef</creatorcontrib><creatorcontrib>Hána, Václav</creatorcontrib><creatorcontrib>Kršek, Michal</creatorcontrib><creatorcontrib>Weiss, Vladimír</creatorcontrib><creatorcontrib>Vladyka, Vilibald</creatorcontrib><creatorcontrib>Lišák, Roman</creatorcontrib><creatorcontrib>Vymazal, Josef</creatorcontrib><creatorcontrib>Pecen, Ladislav</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical endocrinology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ježková, Jana</au><au>Marek, Josef</au><au>Hána, Václav</au><au>Kršek, Michal</au><au>Weiss, Vladimír</au><au>Vladyka, Vilibald</au><au>Lišák, Roman</au><au>Vymazal, Josef</au><au>Pecen, Ladislav</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gamma knife radiosurgery for acromegaly - long-term experience</atitle><jtitle>Clinical endocrinology (Oxford)</jtitle><addtitle>Clin Endocrinol (Oxf)</addtitle><date>2006-05</date><risdate>2006</risdate><volume>64</volume><issue>5</issue><spage>588</spage><epage>595</epage><pages>588-595</pages><issn>0300-0664</issn><eissn>1365-2265</eissn><coden>CLECAP</coden><abstract>Summary
Objective The Leksell gamma knife (LGK) is one of the treatment options for pituitary adenomas. We report on our long‐term experience treating acromegaly using LGK.
Design Since 1993 we have followed 96 acromegaly patients through periods of from 12 to 120 months. The mean follow‐up period was 53·7 ± 26·8 months. Seventy‐two patients were treated with neurosurgery prior to LGK; for 24 LGK was the primary treatment. Thirteen patients were irradiated twice, due to persistent activity of the adenoma or its residue. Pituitary functions were tested at 6‐month intervals, post‐irradiation. The target tumour volume for radiosurgery was between 93·3 and 12 700 mm3 (median 1350 mm3).
Results Fifty per cent of the patients achieved mean GH < 2·5 µg/l within 42 months, normalized their IGF‐I within 54 months, and achieved GH suppression in the oral glucose tolerance test (oGTT) < 1 µg/l with normal IGF‐I within 66 months. LGK effectiveness was dependent on initial adenoma hormonal activity (GH and IGF‐I serum levels), not on the size of the adenoma. Patients with primary neurosurgery followed by LGK irradiation had better outcomes than those with LGK alone. Irradiation arrested all adenoma growth, causing tumour shrinkage in 62·3% of patients. Twenty‐six developed hypopituitarism when irradiated by 15 Gy (or more) on functional peritumoral pituitary tissue. No hypopituitarism appeared using lower doses.
Conclusions In acromegaly, LGK is a useful adjunct to primary neurosurgery when treating post‐surgical residues because it can limit the duration of medical therapy. It can be used as a primary therapy when neurosurgery is not possible.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>16649981</pmid><doi>10.1111/j.1365-2265.2006.02513.x</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0300-0664 |
| ispartof | Clinical endocrinology (Oxford), 2006-05, Vol.64 (5), p.588-595 |
| issn | 0300-0664 1365-2265 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_67928705 |
| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Acromegaly - blood Acromegaly - etiology Acromegaly - surgery Adenoma - blood Adenoma - complications Adenoma - surgery Adolescent Adult Aged Biological and medical sciences Blood Glucose - analysis Combined Modality Therapy Endocrinopathies Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Growth Hormone - blood Humans Hypothalamus. Hypophysis. Epiphysis (diseases) Insulin-Like Growth Factor I - analysis Male Medical sciences Middle Aged Neurosurgical Procedures Non tumoral diseases. Target tissue resistance. Benign neoplasms Pituitary Neoplasms - blood Pituitary Neoplasms - complications Pituitary Neoplasms - surgery Radiosurgery - instrumentation Statistics, Nonparametric Treatment Outcome Vertebrates: endocrinology |
| title | Gamma knife radiosurgery for acromegaly - long-term experience |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T05%3A57%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Gamma%20knife%20radiosurgery%20for%20acromegaly%20-%20long-term%20experience&rft.jtitle=Clinical%20endocrinology%20(Oxford)&rft.au=Je%C5%BEkov%C3%A1,%20Jana&rft.date=2006-05&rft.volume=64&rft.issue=5&rft.spage=588&rft.epage=595&rft.pages=588-595&rft.issn=0300-0664&rft.eissn=1365-2265&rft.coden=CLECAP&rft_id=info:doi/10.1111/j.1365-2265.2006.02513.x&rft_dat=%3Cproquest_cross%3E1058387641%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c5283-14502d9338e6011a1cc44c42eb73c49f03086f9b697e4e770fb73e3ec2ce419d3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=198815932&rft_id=info:pmid/16649981&rfr_iscdi=true |