Title :

Gamma Knife radiosurgery for acromegaly: evaluating the role of the biological effective dose associated with endocrine remission in a series of 42 consecutive cases.

Author(s) :

Balossier, Anne [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Tuleasca, Constantin [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital [Lausanne] [CHUV]
Signal Processing Laboratory [Lausanne] [LTS5]
Cortet-Rudelli, Christine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Service Endocrinologie, diabétologie, maladies métaboliques et nutrition [LILLE - Endocrino]
Soto-Ares, Gustavo [Auteur]
Services de neuroradiologie [Lille]
Levivier, Marc [Auteur]
Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital [Lausanne] [CHUV]
Assaker, Richard [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
Reyns, Nicolas [Auteur]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189

Journal title :

Clinical Endocrinology

Abbreviated title :

Clin. Endocrinol. (Oxf)

Publication date :

2020-10-03

ISSN :

1365-2265

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Introduction Stereotactic radiosurgery (SRS) is a valuable treatment option for persistent and/or recurrent acromegaly secondary to growth hormone (GH) secreting pituitary adenoma (PA). Here, we assess the role of biological ...
Show more >Introduction Stereotactic radiosurgery (SRS) is a valuable treatment option for persistent and/or recurrent acromegaly secondary to growth hormone (GH) secreting pituitary adenoma (PA). Here, we assess the role of biological effective dose (BED) received by PA treated with SRS in relation with endocrine remission. Methods Forty-two patients (minimum 6 months follow-up) were included. Mean marginal dose was 27.7 (median 28, 20–35), and mean BED received by tumour was 193.1 Gy2.47 (median 199.7, 64.1–237.1). Based on the median values, we divided the patients in high tumour BED group (H-BEDtm, 199.7–237.1 Gy2.47, n = 12) and low BED one (L- BEDtm, 64.1–199.7 Gy2.47, n = 10). The two groups did not differ by pretherapeutic IGF-1 levels (p = .1) or by the prescribed dose (p = .6). Results Mean follow-up period was 62.5 months (median 60.5, 9–127). Probability of IGF-1 normalization was 65% at 3 years and 72.4% at 4 years, remaining stable until last follow-up. Twenty-two (52.4%) patients had complete endocrine remission in absence of any Somatostatin analogues. Actuarial rates were 33% at 3 years and 57.4% at 7 years, further remaining stable during follow-up course. In univariate analysis, only statistically significant parameter was pretherapeutic serum IGF-1 and IGF-1 index (p = .01). Five patients (5/26, 19.3%) without previous hypopituitarism developed new pituitary insufficiency. H-BEDtm was associated with higher rates of endocrine remission compared with L-BEDtm, with actuarial probability of 70.2% versus 48.2% at 9 years, although this did not reach statistical significance (p > .05). Conclusion Our study confirms that SRS by Gamma Knife is safe and effective for GH-secreting PA. Pretherapeutic serum levels of IGF-1 were only statistically significant parameter for endocrine remission.Show less >

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
• Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189

Submission date :

2023-12-13T05:15:48Z
2024-01-31T11:41:30Z