Table 2.
Summary of efficacy and side-effects of radiation therapy methods in patients with acromegaly
| RT Type | No of studies | Patients | Dose (Gy), median | Follow-up (median, months) | Tumor control (%) | Hormonal remission (%) | New Hypopituitarism (%) | Visual defects (%) | Brain radionecrosis (%) | Second brain tumor (%) |
|
SRS type: GK |
26 | 1536 | 23 | 58 | 98 (93-100) |
46 (17-65) 52 at 5y |
22 (2-58) | 1.5 (0–4) | 0.5 | 0 |
| CK | 3 | 67 | 22.5 | 33 | 99 | 22.5 (17-44) | 6.5 (0–33) | 0 | 0 | 0 |
| LINAC | 4 | 193 | 19 | 69 | 96 | 39 (23-68) | 20.5 (12 – 46) | 1.8 (0 – 3) | 3.3 | 0-1 |
| Proton | 2 | 72 | 20 | 58 | 98.5 | 51 (50-67) | 51 (62 at 5y) | 0 | 1.4 | 0 |
| CRT | 9 | 1383 | 46.5 | 99 | 98 | 56 (36 at 5y) | 33 (35 at 5y) | 0.8 (0–5) | 2.5 (0–3) | 0–2 in 20 years* |
| FSRT | 8 | 261 | 49 | 71 | 97 (92-100) |
35 (25 at 5y) | 29 (22-39) | 1.8 (0–5) | 0 | 0.3 (0–1) |
Legend. The results are expressed in weighted means calculated from the published studies; SRS = stereotactic radiosurgery; CRT = conventional fractionated radiotherapy; FSRT = fractionated stereotactic radiotherapy; GK = gamma knife radiosurgery; LINAC = linear accelerator radiosurgery; CK = Cyberknife radiosurgery; y = years; * actuarial rates in 331 various pituitary adenomas (17).