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Efficacy and safety of CyberKnife radiosurgery for acromegaly

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An Erratum to this article was published on 20 March 2007

Abstract

Objective

Acromegaly is a disease characterized by GH hypersecretion, and is typically caused by a pituitary somatotroph adenoma. The primary mode of therapy is surgery, and radiotherapy is utilized as an adjuvant strategy to treat persistent disease. The aim of this study was to determine the efficacy and tolerability of CyberKnife stereotactic radiosurgery in acromegaly.

Design

A retrospective review of biochemical and imaging data for subjects with acromegaly treated with CyberKnife stereotactic radiosurgery between 1998 and 2005 at Stanford University Hospital.

Patients

Nine patients with active acromegaly were treated with radiosurgery using the CyberKnife (CK).

Measurements

Biochemical response based on serum insulin-like growth factor-1 (IGF-1), anterior pituitary hormone function, and tumor size with MRI scans were analyzed.

Results

After a mean follow up of 25.4 months (range, 6–53 months), CK radiosurgery resulted in complete biochemical remission in 4 (44.4%) subjects, and in biochemical control with the concomitant use of a somatostatin analog in an additional subject. Smaller tumor size was predictive of treatment success: baseline tumor volume was 1.28 cc (± 0.81, SD) vs. 3.93 cc (± 1.54) in subjects with a normal IGF-1 vs. those with persistent, active disease, respectively (P = 0.02). The mean biologically effective dose (BED) was higher in subjects who achieved a normal IGF-1 vs. those with persistent, active disease, 172 Gy3 (±28) vs. 94 Gy3 (±17), respectively (P < 0.01). At least one new anterior pituitary hormone deficiency was observed after CK in 3 (33%) patients: two developed hypogonadism, and one developed panhypopituitarism.

Conclusions

CK radiosurgery may be a valuable adjuvant therapy for the management of acromegaly.

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Acknowledgements

We thank Lynn Remedios for her assistance with the statistical analysis.

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Authors and Affiliations

  1. Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Brian K. Roberts, Daniel L. Ouyang & Laurence Katznelson

  2. Department of Radiation Oncology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Scott G. Soltys & Iris C. Gibbs

  3. Department of Neurosurgery, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Shivanand P. Lad, Steven D. Chang, Griffith R. Harsh IV, John R. Adler Jr. & Laurence Katznelson

  4. Stanford Cancer Center, 875 Blake Wilbur Dr., Stanford, CA, 94305-5826, USA

    Laurence Katznelson

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  1. Brian K. Roberts
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Correspondence to Laurence Katznelson.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s11102-007-0024-z.

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Roberts, B.K., Ouyang, D.L., Lad, S.P. et al. Efficacy and safety of CyberKnife radiosurgery for acromegaly. Pituitary 10, 19–25 (2007). https://doi.org/10.1007/s11102-007-0004-3

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