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Gamma knife radiosurgery for acromegaly--long-term experience
Jana Jezková1, Josef Marek, Václav Hána
1Third Department of Medicine, First Medical Faculty, Charles University, Prague, Czech Republic. fjjezek@cmail.cz
Clinical Endocrinology
|May 3, 2006
Summary
Leksell gamma knife (LGK) effectively treats acromegaly, especially after surgery. It helps control growth hormone and IGF-I levels, with outcomes depending on initial tumor activity, not size.
Area of Science:
- Neurosurgery
- Endocrinology
- Radiation Oncology
Background:
- Acromegaly, a condition caused by excess growth hormone, is often treated with surgery.
- The Leksell gamma knife (LGK) is an alternative or adjunctive therapy for pituitary adenomas.
Purpose of the Study:
- To evaluate the long-term effectiveness and safety of LGK in treating acromegaly patients.
- To compare outcomes of LGK as primary treatment versus adjuvant therapy.
Main Methods:
- A cohort of 96 acromegaly patients treated with LGK between 1993 and 2003 was retrospectively analyzed.
- Patients underwent follow-up for 12-120 months, with pituitary function tests every 6 months.
- Treatment strategies included LGK as primary therapy (24 patients) or after neurosurgery (72 patients).
Main Results:
- 50% of patients achieved normalized IGF-I levels within 54 months.
- LGK effectiveness correlated with initial hormonal activity, not tumor size.
- Tumor growth was arrested in all patients, with shrinkage in 62.3%; hypopituitarism occurred with doses ≥15 Gy.
Conclusions:
- LGK is a valuable tool for managing residual pituitary adenomas post-surgery, potentially reducing the need for medical therapy.
- LGK serves as a viable primary treatment option when neurosurgery is contraindicated.
