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Stereotactic radiosurgery for nonfunctioning pituitary tumor: A multicenter study of new pituitary hormone deficiency
C. Dumot, G. Mantziaris, S. Dayawansa, S. Peker, Y. Samanci, AM. Nabeel, WA. Reda, SR. Tawadros, K. Abdelkarim, AMN. El-Shehaby, RM. Emad, AR. Abdelsalam, R. Liscak, J. May, E. Mashiach, F. De Nigris Vasconcellos, K. Bernstein, D. Kondziolka, H....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu multicentrická studie, časopisecké články
NLK
Free Medical Journals
od 1999 do Před 1 rokem
PubMed Central
od 1999 do Před 1 rokem
Europe PubMed Central
od 1999 do Před 1 rokem
Open Access Digital Library
od 1999-01-01
Medline Complete (EBSCOhost)
od 2004-01-01 do Před 1 rokem
PubMed
38095431
DOI
10.1093/neuonc/noad215
Knihovny.cz E-zdroje
- MeSH
- hypofyzární hormony MeSH
- hypopituitarismus * komplikace chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory hypofýzy * radioterapie chirurgie MeSH
- následné studie MeSH
- radiochirurgie * metody MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: SRS provides long-term tumor control with a 15.3% risk of hypopituitarism at 10 years.
Allegheny Health Network Cancer Institute Allegheny Health Network Pittsburgh Pennsylvania USA
College of Medecine Drexel University Philadelphia Pennsylvania USA
Department of Medicine University of Virginia Charlottesville Virginia USA
Department of Neurological Surgery Hospices civils de Lyon Lyon France
Department of Neurological Surgery University of Virginia Charlottesville Virginia USA
Department of Neurosurgery Allegheny Health Network Pittsburgh Pennsylvania USA
Department of Neurosurgery Koc University School of Medicine Istanbul Turkey
Department of Neurosurgery NYU Langone New York City New York USA
Department of Neurosurgery University of Miami Miami Florida USA
Department of Radiation Oncology National Cancer Institute Cairo University Cairo Egypt
Department of Radiation Oncology NYU Langone New York City New York USA
Department of Radiation Oncology University of Miami Miami Florida USA
Department of Stereotactic and Radiation Neurosurgery Na Homolce Hospital Prague Czech Republic
Departments of Clinical Oncology Ain Shams University Cairo Egypt
Departments of Neurosurgery Ain Shams University Cairo Egypt
Departments of Neurosurgery University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
Gamma Knife Center Cairo Nasser Institute Hospital Cairo Egypt
Neurosurgery Department Military Medical Academy Cairo Egypt
Citace poskytuje Crossref.org
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