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Risk of new tumor, carotid stenosis, and stroke after stereotactic radiosurgery for pituitary tumor: A multicenter study of 2254 patients with imaging follow-up

C. Dumot, G. Mantziaris, S. Dayawansa, C. Brantley, CC. Lee, HC. Yang, S. Peker, Y. Samanci, D. Mathieu, JN. Tourigny, N. Martinez Moreno, R. Martinez Alvarez, T. Chytka, R. Liscak, H. Speckter, E. Lazo, A. Brito, P. Picozzi, A. Franzini, J....

. 2024 ; 26 (12) : 2328-2338. [pub] 20241205

Language English Country England, Great Britain

Document type Journal Article, Multicenter Study

Persistent link   https://www.medvik.cz/link/bmc25003082
E-resources Online Full text

NLK Free Medical Journals from 1999 to 1 year ago
PubMed Central from 1999 to 1 year ago
Europe PubMed Central from 1999 to 1 year ago
Open Access Digital Library from 1999-01-01
Medline Complete (EBSCOhost) from 2004-01-01 to 1 year ago

Links

PubMed 39028740
DOI 10.1093/neuonc/noae133
Knihovny.cz E-resources

BACKGROUND: A higher risk of secondary brain tumor, carotid stenosis, and stroke has been reported after conventional sella irradiation for pituitary neuroendocrine tumors (PitNET). Stereotactic radiosurgery (SRS), which is a more focused approach, is now increasingly used instead. The aim was to assess the risk of secondary brain tumor, carotid stenosis/occlusion, and stroke after SRS. METHODS: In this multicentric retrospective study, 2254 patients with PitNET were studied, 1377 in the exposed group, and 877 in the control group. RESULTS: There were 9840.1 patient-years at risk for the SRS and 5266.5 for the control group. The 15-year cumulative probability of secondary intracranial tumor was 2.3% (95% CI: 0.5%, 4.1%) for SRS and 3.7% (95% CI: 0%, 8.7%) for the control group (P = .6), with an incidence rate of 1.32 per 1000 and 0.95 per 1000, respectively. SRS was not associated with an increased risk of tumorigenesis when stratified by age (HR: 1.59 [95% CI: 0.57, 4.47], Pp = .38). The 15-year probability of new carotid stenosis/occlusion was 0.9% (95% CI: 0.2, 1.6) in the SRS and 2% (95% CI: 0, 4.4) in the control group (P = .8). The 15-year probability of stroke was 2.6% (95% CI: 0.6%, 4.6%) in the SRS and 11.1% (95% CI: 6%, 15.9%) in the control group (P < .001). In Cox multivariate analysis stratified by age, SRS (HR 1.85 [95% CI:0.64, 5.35], P = .26) was not associated with risk of new stroke. CONCLUSIONS: No increased risk of long-term secondary brain tumor, new stenosis or occlusion, and stroke was demonstrated in the SRS group compared to the control in this study with imaging surveillance.

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