Efficiency and safety of cyberKnife robotic radiosurgery in the multimodal management of patients with acromegaly
Journal
Cancers
ISSN
2072-6694
Date Issued
2023
Author(s)
Romero-Gameros, Carlos Alfonso
González-Virla, Baldomero
Vargas-Ortega, Guadalupe
Sosa-Eroza , Ernesto
Balcázar-Hernández, Lourdes Josefina
Mercado, Moises
Velasco-Cortes, Novelthys
Rodea-Ávila, Carlos Aaron
Flores-Robles, Luis
Lorenzana-Hernández, José Armando
Vázquez-Rojas, José
López-Palma, Margarita
Type
text::journal::journal article
Abstract
Objective: To analyze, in a cohort of acromegalic patients, the results of the efficiency and safety of radiosurgery (CyberKnife), as well as the prognostic factors associated with disease remission. Material and methods: Observational, retrospective, longitudinal, and analytical study that included acromegalic patients with persistent biochemical activity after initial medical–surgical treatment, who received treatment with CyberKnife radiosurgery. GH and IGF-1 levels at baseline after one year and at the end of follow-up were evaluated. Results: 57 patients were included, with a median follow-up of four years (IQR, 2–7.2 years). The biochemical remission rate was 45.6%, 33.33% achieved biochemical control, and 12.28% attained biochemical cure at the end of follow-up. A progressive and statistically significant decrease was observed in the comparison of the concentrations of IGF-1, IFG-1 x ULN, and baseline GH at one year and at the end of follow-up. Both cavernous sinus invasion and elevated baseline IGF-1 x ULN concentrations were associated with an increased risk of biochemical non-remission. Conclusion: Radiosurgery (CyberKnife) is a safe and effective technique in the adjuvant treatment of GH-producing tumors. Elevated levels of IGF x ULN before radiosurgery and invasion of the cavernous sinus by the tumor could be predictors of biochemical non-remission of acromegaly. © 2023 by the authors.