Pituitary neuroendocrine tumors treated with stereotactic radiosurgery.

IF 3.2 2区 医学 Q2 CLINICAL NEUROLOGY Journal of Neuro-Oncology Pub Date : 2024-10-28 DOI:10.1007/s11060-024-04864-3
Inhwa Kim, Michael Yan, Michel Sourour, Robert Heaton, Colin Faulkner, Aristotelis Kalyvas, Dana M Keilty, Michael D Cusimano, David Payne, Normand Laperriere, David B Shultz, Saira B Alli, Gelareh Zadeh, Derek S Tsang
{"title":"Pituitary neuroendocrine tumors treated with stereotactic radiosurgery.","authors":"Inhwa Kim, Michael Yan, Michel Sourour, Robert Heaton, Colin Faulkner, Aristotelis Kalyvas, Dana M Keilty, Michael D Cusimano, David Payne, Normand Laperriere, David B Shultz, Saira B Alli, Gelareh Zadeh, Derek S Tsang","doi":"10.1007/s11060-024-04864-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Pituitary neuroendocrine tumors (pitNETs) are benign tumors that may recur after surgical resection or persist following medical management. The objective of this study was to evaluate outcomes and toxicities of patients with pitNETs treated with stereotactic radiosurgery (SRS) at a single institution.</p><p><strong>Methods: </strong>We completed a retrospective, single-institution study of patients with pitNETs treated with frame-based, single-fraction, cobalt-60 SRS between September 2005 and June 2023. The primary endpoint was local tumor control. Secondary endpoints included endocrine control (for functional tumors), overall survival, and toxicities.</p><p><strong>Results: </strong>A total of 88 lesions in 83 patients were treated with SRS. Most lesions (70%) were non-functional tumors. Of the 26 functioning tumors, 6 patients achieved endocrine remission with SRS alone (23%), and the remainder achieved remission with combined medical management. With a median patient follow-up of 4.7 years, no local tumor recurrences were observed with an estimated local control probability of 100%. Two- and five-year overall survival estimates were 97% (95% confidence interval [CI] 89-99) and 95% (95% CI 84-98), respectively. Causes of death were unrelated to PitNET or SRS. Twelve patients (14%) developed hypopituitarism after SRS. Despite the 34 lesions that were ≤ 3 mm from optic structures, no patients developed any optic neuropathy or visual decline post SRS.</p><p><strong>Conclusions: </strong>SRS is a highly effective modality for recurrent or residual pitNETs. This study observed a local control of 100% with no cases of optic toxicities after a median follow-up of 4.7 years. These observed findings suggest that dose de-escalation may be possible for future treatment of pitNETs.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuro-Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11060-024-04864-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: Pituitary neuroendocrine tumors (pitNETs) are benign tumors that may recur after surgical resection or persist following medical management. The objective of this study was to evaluate outcomes and toxicities of patients with pitNETs treated with stereotactic radiosurgery (SRS) at a single institution.

Methods: We completed a retrospective, single-institution study of patients with pitNETs treated with frame-based, single-fraction, cobalt-60 SRS between September 2005 and June 2023. The primary endpoint was local tumor control. Secondary endpoints included endocrine control (for functional tumors), overall survival, and toxicities.

Results: A total of 88 lesions in 83 patients were treated with SRS. Most lesions (70%) were non-functional tumors. Of the 26 functioning tumors, 6 patients achieved endocrine remission with SRS alone (23%), and the remainder achieved remission with combined medical management. With a median patient follow-up of 4.7 years, no local tumor recurrences were observed with an estimated local control probability of 100%. Two- and five-year overall survival estimates were 97% (95% confidence interval [CI] 89-99) and 95% (95% CI 84-98), respectively. Causes of death were unrelated to PitNET or SRS. Twelve patients (14%) developed hypopituitarism after SRS. Despite the 34 lesions that were ≤ 3 mm from optic structures, no patients developed any optic neuropathy or visual decline post SRS.

Conclusions: SRS is a highly effective modality for recurrent or residual pitNETs. This study observed a local control of 100% with no cases of optic toxicities after a median follow-up of 4.7 years. These observed findings suggest that dose de-escalation may be possible for future treatment of pitNETs.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
用立体定向放射外科手术治疗垂体神经内分泌肿瘤。
目的:垂体神经内分泌肿瘤(pituitary neuroendocrine tumors,pitNETs)是一种良性肿瘤,手术切除后可能复发,药物治疗后也可能持续存在。本研究的目的是评估单一机构采用立体定向放射手术(SRS)治疗垂体神经内分泌肿瘤患者的疗效和毒性:我们对 2005 年 9 月至 2023 年 6 月间接受基于框架、单分量、钴-60 SRS 治疗的洼地网状细胞瘤患者进行了一项单一机构的回顾性研究。主要终点是局部肿瘤控制。次要终点包括内分泌控制(功能性肿瘤)、总生存期和毒性反应:共有 83 名患者的 88 个病灶接受了 SRS 治疗。大多数病变(70%)为无功能肿瘤。在26个有功能的肿瘤中,6名患者仅通过SRS治疗(23%)就获得了内分泌缓解,其余患者通过联合药物治疗获得了缓解。患者中位随访时间为4.7年,未观察到局部肿瘤复发,估计局部控制概率为100%。两年和五年总生存率分别为97%(95%置信区间[CI] 89-99)和95%(95%置信区间[CI] 84-98)。死亡原因与PitNET或SRS无关。12名患者(14%)在SRS后出现垂体功能减退。尽管有34个病灶距离视神经结构≤3毫米,但没有患者在SRS术后出现视神经病变或视力下降:结论:SRS是一种治疗复发或残留凹陷性神经网的高效方法。本研究观察到,在中位随访 4.7 年后,局部控制率达到 100%,且无视神经毒性病例。这些观察结果表明,在未来的洼地网状细胞瘤治疗中可能会降低剂量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Journal of Neuro-Oncology
Journal of Neuro-Oncology 医学-临床神经学
CiteScore
6.60
自引率
7.70%
发文量
277
审稿时长
3.3 months
期刊介绍: The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.
期刊最新文献
A systematic review of stereotactic radiosurgery for metastatic spinal sarcomas. BRD4 promotes immune escape of glioma cells by upregulating PD-L1 expression. Ends of the spectrum best practices for early detection and multidisciplinary management of acromegaly. Transient and permanent hydrocephalus following resection of brain metastases located in the posterior fossa: incidence, risk factors and the necessity of perioperative external ventricular drainage placement. Higher isoform of hnRNPA1 confer Temozolomide resistance in U87MG & LN229 glioma cells.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1