Gamma knife radiosurgery for growth hormone-producing adenomas.
We evaluated the endocrinological outcomes of gamma knife radiosurgery (GKS) for the treatment of growth hormone (GH)-producing pituitary adenomas. Twenty-six patients treated with GKS (median treatment [tumour] volume: 0.8 mL; median marginal radiation dose: 20Gy) were followed for a median of 84 months. "Disease remission" was defined as either nadir levels of GH <1 microg/L during an oral glucose load, or random GH levels <2 microg/L and normal age-adjusted and sex-adjusted levels of insulin-like growth factor without pituitary suppressive medications. The remission rate was 38% (10/26) and the 5-year and 10-year actuarial remission rates were 16.9% and 47.4%, respectively. Two patients (8%) suffered hypopituitarism requiring medication, but no other serious deficits were observed. Although GKS requires a relatively long time to achieve hormonal remission, it is a very useful, long-term treatment for GH-producing adenomas. We propose that compared to continuing life-long medication, GKS is less invasive and more cost effective.
Iwai
Yoshiyasu
Y
Department of Neurosurgery, Osaka City General Hospital, 2-13-22, Miyakojima-hondohri, Miyakojima-ku, Osaka 534-0021, Japan. y-iwai@rc5.so-net.ne.jp
Yamanaka
Kazuhiro
K
Yoshimura
Masaki
M
Kawasaki
Isao
I
Yamagami
Keiko
K
Yoshioka
Katsunobu
K
D000236:Adenoma / Q000378:metabolism* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000378:metabolism* / Q000601:surgery*; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
D018931:Antineoplastic Agents, Hormonal; D019382:Human Growth Hormone; D015282:Octreotide