Back to Search
Start Over
Updates in the outcomes of radiation therapy for Cushing's disease
- Source :
- Best practiceresearch. Clinical endocrinologymetabolism. 35(2)
- Publication Year :
- 2021
-
Abstract
- External radiation therapy (RT) directed to the pituitary gland is generally recommended in patients with Cushing's disease (CD) as adjuvant to transsphenoidal surgery, among other second-line therapies offered to patients with residual or recurrent hypercortisolism (i.e., medical treatment, repeat surgery or bilateral adrenalectomy). RT is effective for the control of tumor growth, even in invasive tumors and in Nelson's syndrome. Progress in radiation stereotactic techniques lead to improved tumor targeting and radiation delivery, thus sparing the adjacent brain structures. Stereotactic RT is associated with a 55-65% rate of cortisol normalization after several months to a few years and potentially with a lower risk of long-term complications, compared with conventional RT. Cortisol-lowering medical therapy is recommended while awaiting the radiation effects. Hypopituitarism is the most frequent side-effect, damage to optic or cranial nerves or second brain tumors are rarely reported. This review presents the updates in the efficacy and safety of the stereotactic radiation techniques in CD patients. Practical points which should be considered by the clinician before recommending RT are also presented.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
030209 endocrinology & metabolism
Hypopituitarism
Lower risk
Radiosurgery
Nelson Syndrome
03 medical and health sciences
0302 clinical medicine
Endocrinology
medicine
Humans
Pituitary ACTH Hypersecretion
Cushing Syndrome
Transsphenoidal surgery
business.industry
Cranial nerves
Nelson's syndrome
Adrenalectomy
Cushing's disease
medicine.disease
Radiation therapy
030104 developmental biology
Pituitary Gland
Radiology
business
Subjects
Details
- ISSN :
- 18781594
- Volume :
- 35
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Best practiceresearch. Clinical endocrinologymetabolism
- Accession number :
- edsair.doi.dedup.....acb84b27b5de036aba8d272802e7c55a