ECE2020 ePoster Presentations Pituitary and Neuroendocrinology (94 abstracts)
Radiotherapy in acromegaly: a single centre experience
Tanja Rezic 1 , Tanja Skoric Polovina 2 , Ivana Kraljevic 2 , Mirsala Solak 2 , Karin Zibar Tomšić 2 , Anne-Marie Balasko 2 , Tina Dusek 2 , Zdravko Heinrich 2 & Darko Kastelan 2
1Clinical Hospital Dubrava, Department of endocrinology, Zagreb, Croatia; 2University Hospital Centre Zagreb, Department of endocrinology, Zagreb, Croatia
Background: Radiotherapy (conventional and/or radiosurgery) is an effective treatment option in patients with acromegaly when biochemical control of the disease cannot be achieved by medication and/or surgery. Purpose: The aim of our study was to evaluate the efficacy of gamma-knife radiosurgery or conventional radiotherapy in the treatment of GH-secreting pituitary adenomas.
Materials and methods: We conducted a retrospective analysis of 22 acromegaly patients treated with gamma-knife radiosurgery (n = 19), conventional radiotherapy (n = 2) or both methods (n = 1) between 1996 and 2018 at the University Hospital Centre Zagreb. The data were analysed to assess biochemical remission defined as low or normal IGF-1 without IGF-lowering medication. Results
The median follow-up (FU) was 63.5 months (range 14–192 months). A biochemical remission was achieved in 10 patients (45.4%) with the actuarial remission rates of 13.6%, 27.2%, 40.9% and 45.4% at 1, 2, 4 and 5.5 years, respectively. The median time to biochemical remission was 21 months (range 6–66). There were no statistically significant associations between patients age, gender, tumour volume, dose of radiation or duration of FU and biochemical remission. However, there was a trend to higher remission rate in patients with lower IGF-1 before radiotherapy (P = 0.053). Tumour growth control was achieved in all patients. New hormone deficiencies were found in 9 patients (40.9%) (in 6 patients one and in 3 patients two or more hormone deficiencies). This corresponds to the incidence of one new case of hypopituitarism per 5.5 patient-years. Conclusions: Radiotherapy offers endocrine remission and tumour control in a substantial proportion of patients with GH-secreting adenomas. Given a high cost of life-long medical treatment and a moderate risk of hypopituitarism, radiotherapy of GH-secreting pituitary adenomas should be considered in all patients with residual tumour.
Keywords: acromegaly, radiotherapy, gamma-knife.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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