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Background <p>Radiotherapy (RT) plays an important role in the treatment of persistent or recurrent Cushing disease (CD) after primary surgery. We assessed the results for RT using a linear accelerator based (LINAC) stereotactic technique. Primary objectives were progression-free survival (PFS) and time to hormonal disease control (THC).</p> Methods <p>Single-center retrospective cohort in a tertiary, academic hospital assessed between 2008 and 2023.</p> Results <p>Fifty-nine patients (59) patients were assessed. Mean age was 41.9 years (range: 15 to 72 years). Most were female (79.7%). Median lesion size at first visit was 1.49&#xa0;cm (range: 0.3 to 5.2&#xa0;cm). Patients were either treated with fractionated RT (50.8%) or single-fraction radiosurgery (SRS). Cabergoline was used prior (49.2%) and concurrently to RT (38.9%). Ketoconazole during SRT was also largely used (30.5%). Median follow-up was 69.9 months. There were no reported deaths. Median PFS was not reached, mean was 78.5 months. Disease control was reported in 94.9% of patients. Only 3 (5.1%) acquired new hormonal deficits. Univariate analysis showed that no variable impacted either PFS or tumor response. Criteria for hormonal remission at 12 months were reached in 33.9%. Median THC was 37.1 months (interquartile interval 25% 8.2 months to 75% 153.5 months). There were two new cardiac events during follow-up and new Cushing stigmata arise on two patients (3.3%).</p> Conclusion <p>We achieved good results for LINAC-based RT in this large, single center cohort with high tumor control. Among patients with CD treatment options impacted neither PFS nor cure rate in this study.</p>

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Results for LINAC-based radiosurgery or fractionated stereotactic radiotherapy for corticotropic pituitary tumors: a single-center retrospective cohort

  • 期刊论文

  • 发表日期：

    2025年7月8日

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  • Geovanne Pedro Mauro,
  • Leila Maria Da Róz,
  • Vinicius de Carvalho Gico,
  • Eduardo Weltman,
  • Evandro César de Souza,
  • Andrea Glezer,
  • Marcio Carlos Machado,
  • Carlos Gilberto Carlotti,
  • Rosangela Correa Villar

摘要

Background

Radiotherapy (RT) plays an important role in the treatment of persistent or recurrent Cushing disease (CD) after primary surgery. We assessed the results for RT using a linear accelerator based (LINAC) stereotactic technique. Primary objectives were progression-free survival (PFS) and time to hormonal disease control (THC).

Methods

Single-center retrospective cohort in a tertiary, academic hospital assessed between 2008 and 2023.

Results

Fifty-nine patients (59) patients were assessed. Mean age was 41.9 years (range: 15 to 72 years). Most were female (79.7%). Median lesion size at first visit was 1.49 cm (range: 0.3 to 5.2 cm). Patients were either treated with fractionated RT (50.8%) or single-fraction radiosurgery (SRS). Cabergoline was used prior (49.2%) and concurrently to RT (38.9%). Ketoconazole during SRT was also largely used (30.5%). Median follow-up was 69.9 months. There were no reported deaths. Median PFS was not reached, mean was 78.5 months. Disease control was reported in 94.9% of patients. Only 3 (5.1%) acquired new hormonal deficits. Univariate analysis showed that no variable impacted either PFS or tumor response. Criteria for hormonal remission at 12 months were reached in 33.9%. Median THC was 37.1 months (interquartile interval 25% 8.2 months to 75% 153.5 months). There were two new cardiac events during follow-up and new Cushing stigmata arise on two patients (3.3%).

Conclusion

We achieved good results for LINAC-based RT in this large, single center cohort with high tumor control. Among patients with CD treatment options impacted neither PFS nor cure rate in this study.