Results of Gamma Knife Radiosurgery in Acromegaly

Abstract EN

Objective.

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 who had previously received maximal surgical debulking at our hospital.

Methods.

The study was a retrospective analysis of hormonal, radiological, and ophthalmologic data collected in a predefined protocol from 1994 to 2009.

The mean age at treatment was 42.3 years (range 22–67 yy).

103 acromegalic patients participated in the study.

The median follow-up was 71 months (IQ range 43–107).

All patients were treated with GK for residual or recurrent GH-secreting adenoma.

Results.

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 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.

Conclusion.

In a highly selected group of acromegalic patients, GK treatment had good efficacy and safety.