Related Experiment Video
Updated: Jan 28, 2026
Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
Outcomes After Gamma Knife Stereotactic Radiosurgery in Pediatric Patients with Cushing Disease or Acromegaly: A
Adesh Shrivastava1, Nasser Mohammed1, Zhiyuan Xu1
1Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA.
Insights
Gamma Knife radiosurgery (GKRS) shows promise for pediatric pituitary adenomas causing acromegaly or Cushing
Area of Science:
- Pediatric neurosurgery
- Endocrinology
- Radiation oncology
Background:
- Pituitary adenomas are rare intracranial tumors in children, affecting hormone regulation.
- Acromegaly and Cushing's disease (CD) in pediatric patients require effective management strategies.
Purpose of the Study:
- To evaluate the efficacy and safety of Gamma Knife radiosurgery (GKRS) for pediatric acromegaly and Cushing's disease.
- To identify factors predicting treatment outcomes in pediatric pituitary adenoma patients.
Main Methods:
- Retrospective analysis of international consortium data on 36 pediatric patients (24 CD, 12 acromegaly) treated with GKRS.
- Assessment of tumor control, endocrine remission, and adverse effects post-GKRS.
- Statistical analysis to correlate clinical/treatment parameters with outcomes.
Main Results:
- Endocrine remission rates: 80% for CD, 42% for acromegaly.
- Tumor control rates: 87.5% for CD, 42% for acromegaly.
- Hypopituitarism occurred in 7 patients; younger age (<15) and higher margin dose predicted remission.
Conclusions:
- GKRS offers viable endocrine remission and tumor control for pediatric functioning pituitary adenomas.
- Hypopituitarism is the main complication, observed in a minority of patients.
- Long-term surveillance is crucial for pediatric patients due to the risk of delayed complications.
Objective:
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).
Methods:
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.
Results:
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 <15 years (P = 0.015) and margin dose (P = 0.042). The median endocrine follow-up was 63.7 months (range, 7-246 months).
Conclusions:
GKRS affords reasonable rates of endocrine remission and tumor control in most pediatric patients with functioning adenomas. The most common post-GKRS complication was hypopituitarism, although this occurred in only a few patients. Given the larger at-risk period for pediatric patients, further study is required to evaluate for delayed recurrences and hypopituitarism.
More Related Videos
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
02:24Predicting Reaction Outcomes
01:13Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...