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Stereotactic radiosurgery for nonfunctioning pituitary tumor: A multicenter study of new pituitary hormone deficiency
Journal article   Open access   Peer reviewed

Stereotactic radiosurgery for nonfunctioning pituitary tumor: A multicenter study of new pituitary hormone deficiency

Chloe Dumot, Georgios Mantziaris, Sam Dayawansa, Selcuk Peker, Yavuz Samanci, Ahmed M Nabeel, Wael A Reda, Sameh R Tawadros, Khaled Abdelkarim, Amr M N El-Shehaby, …
Neuro-oncology (Charlottesville, Va.), v 26(4), pp 715-723
05 Apr 2024
DOI: https://doi.org/10.1093/neuonc/noad215
PMID: 38095431
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10995514View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Female Follow-Up Studies Humans Hypopituitarism - complications Hypopituitarism - surgery Male Middle Aged Pituitary Hormones Pituitary Neoplasms - radiotherapy Pituitary Neoplasms - surgery Radiosurgery - methods Retrospective Studies Treatment Outcome
Stereotactic radiosurgery (SRS) is used to treat recurrent or residual nonfunctioning pituitary neuroendocrine tumors (NFPA). The objective of the study was to assess imaging and development of new pituitary hormone deficiency. Patients treated with single-session SRS for a NFPA were included in this retrospective, multicenter study. Tumor control and new pituitary dysfunction were evaluated using Cox analysis and Kaplan-Meier curves. A total of 869 patients (male 476 [54.8%], median age at SRS 52.5 years [Interquartile range (IQR): 18.9]) were treated using a median margin dose of 14Gy (IQR: 4) for a median tumor volume of 3.4 cc (IQR: 4.3). With a median radiological follow-up of 3.7 years (IQR: 4.8), volumetric tumor reduction occurred in 451 patients (51.9%), stability in 364 (41.9%) and 54 patients (6.2%) showed tumor progression.The probability of tumor control was 95.5% (95% Confidence Interval [CI]: 93.8-97.3) and 88.8% (95%CI: 85.2-92.5) at 5 and 10 years, respectively. A margin dose >14 Gy was associated with tumor control (Hazard Ratio [HR]:0.33, 95% CI: 0.18-0.60, P < 0.001). The probability of new hypopituitarism was 9.9% (95% CI: 7.3-12.5) and 15.3% (95% CI: 11-19.4) at 5 and 10 years, respectively. A maximum point dose >10 Gy in the pituitary stalk was associated with new pituitary hormone deficiency (HR: 3.47, 95% CI: 1.95-6.19). The cumulative probability of new cortisol, thyroid, gonadotroph, and growth hormone deficiency was 8% (95% CI: 3.9-11.9), 8.3% (95% CI: 3.9-12.5), 3.5% (95% CI: 1.7-5.2), and 4.7% (95% CI: 1.9-7.4), respectively at 10 years. SRS provides long-term tumor control with a 15.3% risk of hypopituitarism at 10 years.

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12 citations in Web of Science
4 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Clinical Neurology
Oncology
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