Stereotactic radiosurgery for secretory pituitary adenomas: systematic review and International Stereotactic Radiosurgery Society practice recommendations

被引：27

作者：

Mathieu, David ^{[1
]}

Kotecha, Rupesh ^{[2
]}

Sahgal, Arjun ^{[3
]}

De Salles, Antonio ^{[4
]}

Fariselli, Laura ^{[5
]}

Pollock, Bruce E. ^{[6
]}

Levivier, Marc ^{[7
,8
]}

Ma, Lijun ^{[9
]}

Paddick, Ian ^{[10
]}

Regis, Jean ^{[11
,12
]}

Yomo, Shoji ^{[13
]}

Suh, John H. ^{[14
]}

Rubens, Muni ^{[2
]}

Sheehan, Jason P. ^{[15
]}

机构：

[1] Univ Sherbrooke, Div Neurosurg, Ctr Rech Ctr Hosp Univ Sherbrooke, Sherbrooke, PQ, Canada

[2] Baptist Hlth South Florida, Miami Canc Inst, Dept Radiat Oncol, Miami, FL USA

[3] Univ Toronto, Dept Radiat Oncol, Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada

[4] Univ Calif Los Angeles, Dept Neurosurg, Los Angeles, CA USA

[5] Fdn IRCCS Ist Neurol Carlo Besta, Radiotherapy Unit, Dept Neurosurg, Milan, Italy

[6] Mayo Clin, Dept Neurol Surg, Rochester, MN USA

[7] Lausanne Univ Hosp, Dept Neurosurg, Lausanne, Switzerland

[8] Lausanne Univ Hosp, Gamma Knife Ctr, Lausanne, Switzerland

[9] Univ Calif San Francisco, Dept Radiat Oncol, San Francisco, CA USA

[10] Med Phys Ltd, Reading, Berks, England

[11] Cromwell Hosp, London, England

[12] Aix Marseille Univ, Funct & Stereotax Neurosurg Dept, Clin Neurosci Federat, La Timone Hosp, Marseille, France

[13] Aizawa Hosp, Aizawa Comprehens Canc Ctr, Div Radiat Oncol, Matsumoto, Nagano, Japan

[14] Cleveland Clin, Dept Radiat Oncol, Taussig Canc Inst, Cleveland, OH 44106 USA

[15] Univ Virginia, Dept Neurol Surg, Charlottesville, VA USA

来源：

JOURNAL OF NEUROSURGERY | 2022年 / 136卷 / 03期

关键词：

acromegaly; Cushing's disease; prolactinomas; secretory pituitary adenomas; pituitary surgery; stereotactic radiosurgery; GAMMA-KNIFE RADIOSURGERY; LINEAR-ACCELERATOR RADIOSURGERY; SINGLE CENTERS EXPERIENCE; CUSHINGS-DISEASE; FOLLOW-UP; SURGERY; MANAGEMENT; MACROADENOMAS; RADIOTHERAPY; CYBERKNIFE;

D O I：

10.3171/2021.2.JNS204440

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

OBJECTIVE A systematic review was performed to provide objective evidence on the use of stereotactic radiosurgery (SRS) in the management of secretory pituitary adenomas and develop consensus recommendations. METHODS The authors performed a systematic review of the English-language literature up until June 2018 using the PRISMA guidelines. The PubMed (Medline), Embase, and Cochrane databases were searched. A total of 45 articles reporting single-institution outcomes of SRS for acromegaly, Cushing's disease, and prolactinomas were selected and included in the analysis. RESULTS For acromegaly, random effects meta-analysis estimates for crude tumor control rate, crude endocrine remission rate, and any new hypopituitarism rates were 97.0% (95% CI 96.0%-98.0%), 44.0% (95% CI 35.0%-53.0%), and 17.0% (95% CI 13.0%-23.0%), respectively. For Cushing's disease, random effects estimates for crude tumor control rate, crude endocrine remission rate, and any new hypopituitarism rate were 92.0% (95% CI 87.0%-95.0%), 48.0% (95% CI 35.0%-61.0%), and 21.0% (95% CI 13.0%-31.0%), respectively. For prolactinomas, random effects estimates for crude tumor control rate, crude endocrine remission rate, and any new hypopituitarism rate were 93.0% (95% CI 90.0%-95.0%), 28.0% (95% CI 19.0%-39.0%), and 12.0% (95% CI 6.0%-24.0%), respectively. Meta-regression analysis did not show a statistically significant association between mean margin dose with crude endocrine remission rate or mean margin dose with development of any new hypopituitarism rate for any of the secretory subtypes. CONCLUSIONS SRS offers effective tumor control of hormone-producing pituitary adenomas in the majority of patients but a lower rate of endocrine improvement or remission.

引用

页码：801 / 812

页数：12

共 51 条

[1] Gamma knife radiosurgery is a successful adjunctive treatment in Cushing's disease [J].