5 Years Result Of Radio Surgery For Cushing Diseases In Iran

Ali Mohammad1, Mazdak Alikhani1, Maziyar Azar1, Farhad Kazemi1, Bahram Andisheh2

1Iran Gamma Knife Center 2Stockholm University & Karolinska Institute

Keywords: pituitary adenoma, gamma knife, Cushing's disease, radiosurgery, outcome

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     Cushing Diseases is a serious endocrinopathy that if left untreated will be associated with significant morbidity rates. Even in the hands of an experienced neurosurgeon, some patients may not achieve remission after transsphenoidal resection of the adenoma. Gamma Knife radiosurgery (GKRS) is usually reserved as a second line treatment following an initial, unsuccessful attempt at a microsurgical cure.
     The goals of stereotactic radiosurgery in the treatment of Cushing’s disease pituitary tumors are to inactivate adenoma cells, controlling tumor growth and to normalize hormone overproduction. Ideally, these goals are met without damaging the residual normal pituitary gland and surrounding vascular and neuronal structures.
     In our institute 33 patients with Cushing''s diseases 29 patients had previous T.S approach 1 or 2 times.
     The patients were treated by Gamma Knife radio Surgery during Jan 2003 to 2009 with mean follow up of 36 months . All of them were treated with 22-26Gy.
       26 patients (78%) were in remission after a mean 28 months (9-60m) follow up.
     Gamma Knife radiosurgery represents a safe and predominantly effective treatment option for patients with recurrent or persistent Cushing’s disease following an initial resection.
     Gamma Knife Radio Surgery especially as an adjunctive treatment to T.S surgery is an alternative to other therapeutic options in view of their adverse effect.


Project Roles:

A. Mohammad (), M. Alikhani (), M. Azar (), F. Kazemi (), B. Andisheh ()