Gamma Knife radiosurgery for growth hormone-secreting pituitary adenoma

Alberto Franzin1, Marco Losa2, Piero Picozzi, MD3, Giorgio Spatola2, Angelo Bolognesi4, Micol Valle2, Lorenzo Gioia2, Pietro Mortini2

1Mi, Italy 2Dept. of Neurosurgery and Radiosurgery, IRCCS S. Raffaele, Università Vita-Salu 3Department of Neurosurgery, IRCCS San Raffaele 4Dept. of Radiation Oncology, IRCCS S. Raffaele, Milano, Italy

Keywords: pituitary adenoma, outcome, acromegaly, gamma knife, radiosurgery

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     Single-session radiosurgery with Gamma Knife (GK) may be a potential adjuvant treatment in acromegaly.
     We analyzed the safety and efficacy of GK in patients with acromegaly who had previously received maximal surgical debulking at our hospital.
     One hundred and three acromegalic patients, 62 women and 41 men, participated in the study.   The mean age at treatment was 42,3 years (range 22-67 yrs).
     The study was a retrospective analysis of hormonal, radiological, and ophthalmologic data collected in a predefined protocol from 1994 to 2009. The median follow-up was 71 months (interquartile range 43–107 months). All patients were treated with GK for residual or recurrent GH-secreting adenoma.
     Sixty-three patients (61.2%) reached the main outcome of the study. The rate of remission was 58.3% at 5 years (95% CI 47.6– 69.0%). Other 15 patients (14.6%) were in remission after GK while on treatment with somatostatin analogues. No serious side effects occurred after GK. Eight of 102 patients (7.8%) experienced a new deficit of pituitary function. New cases of hypogonadism, hypothyroidism, and hypoadrenalism occurred in 4 of 77 patients (5.2%), 3 of 95 patients (3.2%), and 6 of 100 patients at risk (6.0%), respectively.
     This was a retrospective study.
     In a highly selected group of acromegalic patients, GK treatment had good efficacy and safety.
     This may lead to reconsider the role of GK in the therapeutic algorithm of acromegaly.


Project Roles:

A. Franzin (), M. Losa (), P. Picozzi (), G. Spatola (), A. Bolognesi (), M. Valle (), L. Gioia (), P. Mortini ()