Gamma knife radiosurgery for acromegaly: Outcomes after failed transsphenoidal surgery

Jay Jagannathan, Jason P. Sheehan, Nader Pouratian, Edward R. Laws, Ladislau Steiner, Mary L. Vance

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: This study evaluates the safety and efficacy of gamma knife radiosurgery (GKRS) in patients with a growth hormone-secreting adenoma. METHODS: A retrospective review of data collected from a prospective database of GKRS patients between January 1988 and September 2006 was performed in patients with acromegaly. Successful endocrine outcome was defined as normalization of the insulin-like growth factor level. Tumor volume was also assessed. At least 18 months of follow-up was available in 95 patients who received radiosurgery during the study period. Mean endocrine follow-up was 57 months (range, 18-168 mo). RESULTS: Normal insulin-like growth factor levels were achieved in 50 patients (53%) at an average time of 29.8 months after radiosurgery (median, 23.5 mo). A decrease in tumor volume control was achieved in 83 (92%) of 90 patients. Five patients (6%) had no change in tumor volume, and two patients (2%) had an increase in tumor volume. New endocrine deficiencies developed in 32 patients (34%). Four patients developed new-onset partial visual acuity deficits; three of these patients had received previous conventional fractionated radiation therapy. CONCLUSION: GKRS is a complementary treatment for recurrent or residual growth hormone-secreting pituitary adenomas. Although infrequent, tumor growth, new-onset pituitary hormone deficiency, recurrence, and neurological dysfunction require careful clinical, radiological, and endocrinological follow-up.

Original languageEnglish (US)
Pages (from-to)1262-1269
Number of pages8
JournalNeurosurgery
Volume62
Issue number6
DOIs
StatePublished - Jun 2008
Externally publishedYes

Keywords

  • Acromegaly
  • Gamma
  • Pituitary
  • Radiosurgery
  • Secretory adenoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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