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LINAC-based Stereotactic Radiotherapy for Acromegaly: A Single-center Retrospective Cohort.

Geovanne P Mauro1, Leila M Da Róz2, Vinicius de Carvalho Gico3

  • 1Department of Radiology and Oncology - Discipline of Radiotherapy, Faculdade de Medicina USP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.

Journal of Neurological Surgery. Part B, Skull Base
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Summary
This summary is machine-generated.

Stereotactic radiotherapy (SRT) using LINAC for acromegaly shows high tumor control. Both single-dose (SRS) and fractionated (SFRT) treatments are effective, with similar hormonal control times.

Keywords:
pituitary GH hypersecretionradiosurgeryradiotherapystereotactic

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Area of Science:

  • Neurosurgery
  • Endocrinology
  • Radiation Oncology

Background:

  • Acromegaly is a rare hormonal disorder caused by excess growth hormone.
  • Stereotactic radiotherapy (SRT) is an established treatment for acromegaly, with most data from Gamma Knife.
  • Linear accelerator (LINAC)-based SRT outcomes for acromegaly are less documented.

Purpose of the Study:

  • To evaluate outcomes of LINAC-based stereotactic radiosurgery (SRS) and stereotactic fractionated radiotherapy (SFRT) for acromegaly.
  • To compare the efficacy of SRS versus SFRT in managing acromegaly.
  • To assess tumor control and hormonal remission rates after LINAC-based SRT.

Main Methods:

  • Retrospective cohort study of 48 acromegaly patients treated between 2008 and 2024.
  • Patients received either single-dose stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (SFRT) using a LINAC.
  • Outcomes included tumor control, progression-free survival (PFS), and hormonal remission (time to hormonal control - THC).

Main Results:

  • High tumor control rate (97.9%) was achieved in the cohort.
  • Mean progression-free survival (PFS) was 85.3 months, with no significant difference between SRS and SFRT.
  • Hormonal remission was achieved in 45.8% of patients, with a median time to hormonal control (THC) of 73.1 months, not significantly different between SRS and SFRT.

Conclusions:

  • LINAC-based SRT is effective for acromegaly, offering high tumor control.
  • Both SRS and SFRT demonstrate comparable efficacy in terms of tumor control and hormonal outcomes.
  • Concurrent medical treatments did not significantly impact SRT outcomes.