Back to Search Start Over

Radiation therapy and stereotactic radiosurgery for the treatment of Cushing's disease: an evidence-based review.

Authors :
Starke RM
Williams BJ
Vance ML
Sheehan JP
Source :
Current opinion in endocrinology, diabetes, and obesity [Curr Opin Endocrinol Diabetes Obes] 2010 Aug; Vol. 17 (4), pp. 356-64.
Publication Year :
2010

Abstract

Purpose of Review: The indications, efficacy, and safety of radiation therapy and stereotactic radiosurgery for Cushing's disease are evaluated.We queried PubMed using the terms, 'Cushing's disease', 'radiotherapy', and 'radiosurgery', then evaluated each study for the number of patients, method of radiation delivery, type of radiation therapy or radiosurgical device used, treatment parameters (e.g. maximal dose, tumor margin dose), length of follow-up, tumor-control rate, complications, rate of hormone normalization, newly onset loss of pituitary function, and method used to assess endocrine remission.<br />Recent Findings: A total of 39 peer-reviewed studies with 731 patients were included. The reported rates of tumor-volume control following radiotherapy and radiosurgery vary considerably from 66-100%. Additionally, the reported rates of endocrine remission vary substantially from 17-100%. The incidence of serious complications following radiosurgery is quite low. Although post-treatment hypopituitarism and disease recurrence were uncommon, they did occur, and this underscores the necessity for long-term follow-up in these patients.<br />Summary: Radiosurgery and, in the modern era, less commonly, radiation therapy, offer both well tolerated and reasonably effective treatment for recurrent or residual Cushing's adenomas.

Details

Language :
English
ISSN :
1752-2978
Volume :
17
Issue :
4
Database :
MEDLINE
Journal :
Current opinion in endocrinology, diabetes, and obesity
Publication Type :
Academic Journal
Accession number :
20531182
Full Text :
https://doi.org/10.1097/MED.0b013e32833ab069