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Stereotactic radiosurgery for acromegaly.

Cheng-Chia Lee1, Mary Lee Vance, Zhiyuan Xu

  • 1Departments of Neurological Surgery (C.-C.L., M.L.V., Z.X., C.-P.Y., D.S., B.D., J.S.), Radiation Oncology (J.S.), and Medicine (M.L.V.), University of Virginia, Charlottesville, Virginia 22908; and Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital (C.-C.L.), and School of Medicine, National Yang-Ming University (C.-C.L.), Taipei, Taiwan 11217, Republic of China.

The Journal of Clinical Endocrinology and Metabolism
|January 30, 2014
PubMed
Summary
This summary is machine-generated.

Stereotactic radiosurgery (SRS) effectively treats acromegaly, achieving remission in 65.4% of patients. This safe treatment option offers a low rate of adverse effects, making it a viable therapeutic choice.

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Area of Science:

  • Neurosurgery
  • Endocrinology
  • Oncology

Background:

  • Acromegaly, a condition caused by excess growth hormone (GH), requires effective treatment to prevent complications.
  • Stereotactic radiosurgery (SRS) is an emerging treatment modality for acromegaly, but its efficacy and safety require further evaluation.
  • Understanding prognostic factors is crucial for optimizing SRS outcomes in acromegaly patients.

Purpose of the Study:

  • To evaluate the efficacy and safety of stereotactic radiosurgery (SRS) for treating acromegaly.
  • To identify prognostic factors influencing remission rates and adverse effects following SRS in acromegaly patients.

Main Methods:

  • Retrospective study of 136 acromegaly patients treated with SRS between 1989 and 2012.
  • Diagnosis confirmed by clinical features and biochemical assessment (GH and IGF-1 levels).
  • Remission defined by post-treatment GH levels < 1.0 ng/mL or normal IGF-1 after medication withdrawal; hypopituitarism defined as new hormone deficiencies.

Main Results:

  • A 65.4% remission rate was observed with a median follow-up of 61.5 months; mean time to remission was 27.5 months.
  • Favorable prognostic factors for remission included higher radiation doses and lower initial IGF-1 levels.
  • New pituitary hormone deficiency occurred in 31.6% of patients, with risk factors including higher margin dose and larger tumor volume.

Conclusions:

  • Stereotactic radiosurgery (SRS) provides a reasonable rate of endocrine remission for acromegaly.
  • SRS is generally well-tolerated, with a low incidence of significant adverse effects.
  • SRS is a safe and effective treatment option for select acromegaly patients.