Fractionated radiotherapy and radiosurgery in acromegaly: analysis of 352 patients from the German Acromegaly Registry
| Autor: | U J Knappe, D Petroff, M Quinkler, S M Schmid, C Schöfl, J Schopohl, M R Stieg, A Tönjes |
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| Rok vydání: | 2020 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Urology 030209 endocrinology & metabolism Radiosurgery Cohort Studies Young Adult 03 medical and health sciences Basal (phylogenetics) 0302 clinical medicine Endocrinology Germany Internal medicine Acromegaly medicine Humans Registries Insulin-Like Growth Factor I Retrospective Studies business.industry Remission Induction Dose fractionation Retrospective cohort study General Medicine Odds ratio Middle Aged medicine.disease Combined Modality Therapy Radiation therapy Treatment Outcome 030220 oncology & carcinogenesis Female Dose Fractionation Radiation Growth Hormone-Secreting Pituitary Adenoma business Follow-Up Studies Cohort study |
| Zdroj: | European Journal of Endocrinology. 182:275-284 |
| ISSN: | 1479-683X 0804-4643 |
| DOI: | 10.1530/eje-19-0784 |
| Popis: | Background If biochemical control of acromegaly is not achieved by operation and medication, radiotherapy may be indicated. Objective To describe fractionated radiotherapy (FRT) and stereotactic radiosurgery (SRS) regarding excess of IGF-1 and pituitary function. Design and methods A retrospective analysis of 352 patients (4126 patient-years) from the German Acromegaly Registry was performed. Follow-up was 1.0–45.1 years after radiotherapy. Therapeutic success was defined by low or normal IGF-1 according to center-specific reference ranges without (= remission) or on (= controlled disease) suppressive medication. Results Time between radiotherapy and last follow-up was 13.0 ± 8.2 years for FRT (n = 233) and 8.9 ± 5.0 years for SRS (n = 119, P P P = 0.021). The 10-year calculated remission rate was 48% for FRT and 52% for SRS (95% CI for the difference is −18 to 26% age points, P = 0.74) and the respective controlled disease rate was 23 and 26%. The odds ratio for adrenocorticotropic or thyreotropic insufficiency was 0.54 (95% CI: 0.30–1.00, P = 0.049) in SRS compared to FRT patients. Conclusion Both after FRT and SRS about 75% of patients with acromegaly are in remission or controlled after 10 years. A slightly faster achievement of target values was observed after SRS. The rate of pituitary insufficiency in FRT patients is significantly higher. |
| Databáze: | OpenAIRE |
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