{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:39:37Z","timestamp":1791970777126,"version":"4.3.4"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pituitary"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Acromegaly has high morbidity and mortality when growth hormone secretion remains uncontrolled. Stereotactic radiosurgery (SRS) may be used when pituitary surgery is not suitable or unsuccessful, but there are few very long-term safety data available, especially for significant adverse events such as stroke.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>118 patients with acromegaly were treated with SRS between 1985 and 2015, at the National Centre for Stereotactic Radiosurgery, Sheffield, UK. Data were gathered from case notes, hospital databases, and patient questionnaires. Stroke incidence in comparison to the normal population was quantified using the standardised incidence ratio (SIR), and visual complications assessed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>88% (104\/118) had complete morbidity follow up data for analysis. The mean follow-up was 134\u00a0months, and median SRS dose was 30\u00a0Gy. 81% of tumours had cavernous sinus invasion. There was no excess stroke rate relative to that seen in two age- and sex-matched large population studies (SIR\u2009=\u20091.36, 95% CI 0.27\u20133.96; SIR\u2009=\u20090.52, 95% CI 0.06\u20131.89). In 68\/104 patients who had MRI-guided SRS with no further radiation treatment (SRS or fractionated radiotherapy) there was no loss of visual acuity and 3% developed ophthalmoplegia. There was a positive correlation between\u2009&gt;\u20091 radiation treatment and both ophthalmoplegia and worsening visual acuity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Stroke rate is not increased by SRS for acromegaly. Accurate MRI-based treatment planning and single SRS treatment allow the lowest complication rates. More than one radiation treatment (SRS or fractionated radiotherapy) was associated with increased visual complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11102-021-01149-0","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T19:03:07Z","timestamp":1622055787000},"page":"724-736","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Long-term safety of gamma knife radiosurgery (SRS) for acromegaly"],"prefix":"10.1007","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5245-3659","authenticated-orcid":false,"given":"Hugh P.","family":"Sims\u2010Williams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaveesha","family":"Rajapaksa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Yianni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Walton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Sinha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Radatz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Herbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Bradburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Newell\u2010Price","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,26]]},"reference":[{"issue":"7","key":"1149_CR1","doi-asserted-by":"publisher","first-page":"4081","DOI":"10.1210\/jc.2004-1381","volume":"90","author":"R Kauppinen-Makelin","year":"2005","unstructured":"Kauppinen-Makelin R et al (2005) A nationwide survey of mortality in acromegaly. 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With the exception of the corresponding author: Prof. Newell-Price who reports grants and personal fees from Novartis, grants and personal fees from Diurnal, grants and personal fees from Recordati, grants and personal fees from HRA Pharma, outside the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Due to the study type, this was not required; however this study was registered and approved as a quality improvement project with the institutional research and development department (ref 5693) at Sheffield Teaching Hospitals NHS Trust.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Due to this being a quality improvement project, rather than research, there was no public and patient consultation regarding the key questions, study design etc.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Public\/patient consultation"}},{"value":"It has been submitted separately.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"STROBE statement"}}]}}