| Gamma knife radiosurgery is a successful adjunctive treatment in Cushing's disease. | |
| | |
MedLine Citation:
|
PMID: 17218730 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: Though transsphenoidal surgery remains the first-line treatment of Cushing's disease, recurrence occurs frequently. Conventional radiotherapy and anticortisolic drugs both have adverse effects. Stereotactic radiosurgery needs to be evaluated more precisely. The aim of this study was to determine long-term hormonal effects and tolerance of gamma knife (GK) radiosurgery in Cushing's disease. DESIGN: Forty patients with Cushing's disease treated by GK were prospectively studied over a decade, with a mean follow-up of 54.7 months. Eleven of them were treated with GK as a primary treatment. METHODS: Radiosurgery was performed at the Department of Functional Neurosurgery of Marseille, France, using the Leksell Gamma Unit B and C models. Median margin dose was 29.5 Gy. Patients were considered in remission if they had normalized 24-h free urinary cortisol and suppression of plasma cortisol after low-dose dexamethasone suppression test. RESULTS: Seventeen patients (42.5%) were in remission after a mean of 22 months (range 12-48 months). The two groups did not differ in terms of initial hormonal levels. Target volume was significantly higher in uncured than in remission group (909.8 vs 443 mm(3), P = 0.038). We found a significant difference between patients who were on or off anticortisolic drugs at the time of GK (20 vs 48% patients in remission respectively, P = 0.02). CONCLUSION: With 42% of patients in remission after a median follow-up of 54 months, GK stereotactic radiosurgery, especially as an adjunctive treatment to surgery, may represent an alternative to other therapeutic options in view of their adverse effects. |
| | |
Authors:
|
F Castinetti; M Nagai; H Dufour; J-M Kuhn; I Morange; P Jaquet; B Conte-Devolx; J Regis; T Brue |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: European journal of endocrinology / European Federation of Endocrine Societies Volume: 156 ISSN: 0804-4643 ISO Abbreviation: Eur. J. Endocrinol. Publication Date: 2007 Jan |
Date Detail:
|
Created Date: 2007-01-12 Completed Date: 2007-03-07 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9423848 Medline TA: Eur J Endocrinol Country: England |
Other Details:
|
Languages: eng Pagination: 91-8 Citation Subset: IM |
Affiliation:
|
Federation of Endocrinology, Diabetes, Metabolic Diseases and Nutrition, Hôpital de la Timone, Centre Hospitalier Universitaire de Marseille and Faculté de Médecine, Université de la Méditerranée, 264 rue St Pierre, cedex 5, 13385 Marseille, France. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adrenocorticotropic Hormone / blood Adult Aged Child, Preschool Dexamethasone / diagnostic use Diagnostic Imaging Estradiol / blood Female Follow-Up Studies Humans Hydrocortisone / blood, urine Male Middle Aged Neurosurgical Procedures Pituitary ACTH Hypersecretion / surgery* Radiosurgery* / adverse effects Testosterone / blood Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
50-02-2/Dexamethasone; 50-23-7/Hydrocortisone; 50-28-2/Estradiol; 58-22-0/Testosterone; 9002-60-2/Adrenocorticotropic Hormone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: An IGF-I gene polymorphism modifies the risk of developing persistent microalbuminuria in type 1 dia...
Next Document: Circulating ghrelin levels in girls with central precocious puberty are reduced during treatment wit...