{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T23:18:30Z","timestamp":1783120710471,"version":"3.54.6"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Most results for stereotactic radiotherapy (SRT) for acromegaly patients come from Gamma-Knife series. We aim to describe outcomes for LINAC-based SRT, as well as compare results for single-dose (SRS) and fractionated (SFRT) treatments.<\/jats:p>\n                  <jats:p>Single-center retrospective cohort in a tertiary, academic hospital assessed between 2008 and 2024.<\/jats:p>\n                  <jats:p>A total of 48 patients were assessed for outcomes of acromegaly after SRT. Most of them female (62.5%). Mean age was 42.5 years (range 12\u201373). Median lesion size was 2.1\u2009cm (range 0.2 to 7.2\u2009cm). Among previous deficits, previous hormonal deficits (31.3%) and visual deficits (45.8%) were common. Most patients were diagnosed with pure somatotrophic lesions (87.5%). SRS was done in 16 (33.3%) patients and 32 (66.7%) underwent SFRT. Concurrent octreotide long-acting release (Oct-LAR) (29\/60.4%) and cabergoline (20\/41.7%) were also common. Median follow-up was 85.3 months (8.2\u2013187.9 months). Tumor control was achieved in 47 (97.9%). Mean progression-free survival (PFS) was 85.3 months (92.4 months for SRS and 81.7 months for SFRT, p\u2009=\u20090.42). Univariate analysis showed no variable impacted overall survival (OS), PFS, new visual, or new hormonal disorders. Hormonal remission was achieved in 22 (45.8%) patients. Median time to hormonal disease control (THC) was 73.1 months for the entire cohort, and 45.8 months for SRS patients and 74.7 months for SFRT patients, with no difference between groups ([HR], 0.30; 95% CI, \u22121.14 to 0.53; p\u2009=\u20090.47).<\/jats:p>\n                  <jats:p>We described acromegaly patients treated with LINAC SRS and with the current criteria for hormonal cure. THC was longer for SFRT patients, with no statistical differences. Concurrent treatment did not impact outcomes.<\/jats:p>","DOI":"10.1055\/a-2693-1815","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T22:58:52Z","timestamp":1757458732000},"page":"421-427","source":"Crossref","is-referenced-by-count":0,"title":["LINAC-based Stereotactic Radiotherapy for Acromegaly: A Single-center Retrospective Cohort"],"prefix":"10.1055","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2050-3110","authenticated-orcid":false,"given":"Geovanne P.","family":"Mauro","sequence":"additional","affiliation":[{"name":"Department of Radiology and Oncology \u2013 Discipline of Radiotherapy, Faculdade de Medicina USP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila M.","family":"Da R\u00f3z","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2013 Discipline of Neurosurgery, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinicius de Carvalho","family":"Gico","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo (ICESP), Medical School of Sao Paulo University, Sao Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio Thiago Pereira","family":"Vasconcelos","sequence":"additional","affiliation":[{"name":"Department of Radiology and Oncology \u2013 Discipline of Radiotherapy, Faculdade de Medicina USP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Weltman","sequence":"additional","affiliation":[{"name":"Department of Radiology and Oncology \u2013 Discipline of Radiotherapy, Faculdade de Medicina USP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evandro C.","family":"de Souza","sequence":"additional","affiliation":[{"name":"Department of Neurology \u2013 Discipline of Neurosurgery, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel S.","family":"Jallad","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Cl\u00ednicas, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malebranche Berardo Carneiro","family":"da Cunha Neto","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Cl\u00ednicas, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosangela C.","family":"Villar","sequence":"additional","affiliation":[{"name":"Department of Radiology and Oncology \u2013 Discipline of Radiotherapy, Faculdade de Medicina USP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.3171\/2021.2.JNS204440","article-title":"Stereotactic radiosurgery for secretory pituitary adenomas: systematic review and International Stereotactic Radiosurgery Society practice recommendations","volume":"136","author":"D Mathieu","year":"2021","journal-title":"J Neurosurg"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s11060-020-03552-2","article-title":"Stereotactic radiosurgery for acromegaly: an international systematic review and meta-analysis of clinical outcomes","volume":"148","author":"R Singh","year":"2020","journal-title":"J Neurooncol"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s11060-024-04658-7","article-title":"Assessment of multimodal treatment options in recurrent and persistent acromegaly: a systematic review and meta-analysis","volume":"168","author":"S F Maroufi","year":"2024","journal-title":"J Neurooncol"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/1756-9966-28-36","article-title":"MASEP gamma knife radiosurgery for secretory pituitary adenomas: experience in 347 consecutive cases","volume":"28","author":"H Wan","year":"2009","journal-title":"J Exp Clin Cancer Res"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s11102-023-01360-1","article-title":"Consensus on criteria for acromegaly diagnosis and remission","volume":"27","author":"A Giustina","year":"2024","journal-title":"Pituitary"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.ejca.2016.03.082","article-title":"RECIST 1.1 - Standardisation and disease-specific adaptations: perspectives from the RECIST Working Group","volume":"62","author":"L H Schwartz","year":"2016","journal-title":"Eur J Cancer"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"2632","DOI":"10.1016\/S0140-6736(24)00342-8","article-title":"Hypopituitarism","volume":"403","author":"M Fleseriu","year":"2024","journal-title":"Lancet"},{"key":"ref8","author":"R V Lloyd","year":"2022"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s11060-009-9832-5","article-title":"Stereotactic radiosurgery for pituitary adenomas: a comprehensive review of indications, techniques and long-term results using the Gamma Knife","volume":"92","author":"J Jagannathan","year":"2009","journal-title":"J Neurooncol"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1111\/j.1365-2265.2006.02513.x","article-title":"Gamma knife radiosurgery for acromegaly\u2014long-term experience","volume":"64","author":"J Jezkov\u00e1","year":"2006","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1530\/eje.0.1450717","article-title":"Failure of radiotherapy in acromegaly","volume":"145","author":"R Cozzi","year":"2001","journal-title":"Eur J Endocrinol"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1111\/cen.15112","article-title":"Time to first remission and survival in patients with acromegaly: evidence from the UK Acromegaly Register Study (UKAR)","volume":"101","author":"H Deshmukh","year":"2024","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"01","key":"ref13","first-page":"342034","article-title":"Results of gamma knife radiosurgery in acromegaly","volume":"2012","author":"A Franzin","year":"2012","journal-title":"Int J Endocrinol"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"303","DOI":"10.3171\/2010.5.JNS091635","article-title":"Gamma Knife surgery for pituitary adenomas: factors related to radiological and endocrine outcomes","volume":"114","author":"J P Sheehan","year":"2011","journal-title":"J Neurosurg"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1093\/neuros\/nyy178","article-title":"Stereotactic radiosurgery for acromegaly: an international multicenter retrospective cohort study","volume":"84","author":"D Ding","year":"2019","journal-title":"Neurosurgery"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.3390\/cancers15051438","article-title":"Efficiency and safety of CyberKnife robotic radiosurgery in the multimodal management of patients with acromegaly","volume":"15","author":"C A Romero-Gameros","year":"2023","journal-title":"Cancers (Basel)"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"E20","DOI":"10.1093\/neuros\/nyy410","article-title":"Low-dose gamma knife radiosurgery for acromegaly","volume":"85","author":"F Y Pai","year":"2019","journal-title":"Neurosurgery"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1530\/EJE-07-0189","article-title":"Gamma knife stereotactic radiosurgery for acromegaly","volume":"157","author":"E O Vik-Mo","year":"2007","journal-title":"Eur J Endocrinol"},{"issue":"10","key":"ref19","first-page":"e47936","article-title":"Promising outcomes in acromegaly patients receiving cyberknife stereotactic hypofractionated radiotherapy","volume":"15","author":"R Meral","year":"2023","journal-title":"Cureus"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1007\/s11060-018-2793-9","article-title":"CyberKnife robotic radiosurgery in the multimodal management of acromegaly patients with invasive macroadenoma: a single center's experience","volume":"138","author":"E Sala","year":"2018","journal-title":"J Neurooncol"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s11102-007-0004-3","article-title":"Efficacy and safety of CyberKnife radiosurgery for acromegaly","volume":"10","author":"B K Roberts","year":"2007","journal-title":"Pituitary"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s11060-012-0862-z","article-title":"Gamma knife radiosurgery for clinically persistent acromegaly","volume":"109","author":"X Liu","year":"2012","journal-title":"J Neurooncol"},{"issue":"03","key":"ref23","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.ijrobp.2018.02.023","article-title":"Endocrine remission after pituitary stereotactic radiosurgery: differences in rates of response for matched cohorts of Cushing disease and acromegaly patients","volume":"101","author":"D M Trifiletti","year":"2018","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1080\/02688697.2021.1976393","article-title":"Gamma-knife radiosurgery in acromegaly: the results from the Croatian acromegaly registry","volume":"38","author":"T \u0160kori\u0107 Polovina","year":"2024","journal-title":"Br J Neurosurg"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1210\/jc.2013-3743","article-title":"Stereotactic radiosurgery for acromegaly","volume":"99","author":"C C Lee","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s11060-018-2792-x","article-title":"Factors affecting early versus late remission in acromegaly following stereotactic radiosurgery","volume":"138","author":"M R Patibandla","year":"2018","journal-title":"J Neurooncol"},{"issue":"02","key":"ref27","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s11060-016-2105-1","article-title":"Long-term results of hypofractionated stereotactic radiotherapy with CyberKnife for growth hormone-secreting pituitary adenoma: evaluation by the Cortina consensus","volume":"128","author":"H Iwata","year":"2016","journal-title":"J Neurooncol"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"101335","DOI":"10.1016\/j.ghir.2020.101335","article-title":"Long-term endocrinological outcomes of gamma knife radiosurgery in acromegaly patients","volume":"55","author":"M M Uygur","year":"2020","journal-title":"Growth Horm IGF Res"},{"issue":"04","key":"ref29","first-page":"255","article-title":"Long-term outcomes of acromegaly treated with fractionated stereotactic radiation: case series and literature review","volume":"4","author":"R Rhome","year":"2017","journal-title":"Neurooncol Pract"},{"issue":"11","key":"ref30","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1016\/j.jocn.2012.11.026","article-title":"Acromegaly: a single centre's experience of stereotactic radiosurgery and radiotherapy for growth hormone secreting pituitary tumours with the linear accelerator","volume":"20","author":"P J Wilson","year":"2013","journal-title":"J Clin Neurosci"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1530\/EJE-19-0784","article-title":"Fractionated radiotherapy and radiosurgery in acromegaly: analysis of 352 patients from the German Acromegaly Registry","volume":"182","author":"U J Knappe","year":"2020","journal-title":"Eur J Endocrinol"},{"issue":"03","key":"ref32","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1530\/EJE-21-0729","article-title":"Long-term outcomes of patients with acromegaly: a report from the Swedish Pituitary Register","volume":"186","author":"S Arnard\u00f3ttir","year":"2022","journal-title":"Eur J Endocrinol"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.4158\/EP-2020-0110","article-title":"Comparing stereotactic radiosurgery and fractionated stereotactic radiotherapy in treating patients with growth hormone-secreting adenomas: a systematic review and meta-analysis","author":"Q Zheng","year":"2020","journal-title":"Endocr Pract"},{"issue":"06","key":"ref34","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.3171\/jns.1998.88.6.1002","article-title":"Stereotactic radiosurgery for recurrent surgically treated acromegaly: comparison with fractionated radiotherapy","volume":"88","author":"A M Landolt","year":"1998","journal-title":"J Neurosurg"},{"issue":"02","key":"ref35","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1007\/s12020-019-01955-4","article-title":"Efficacy and safety of fractionated conformal radiation therapy in acromegaly: a long-term follow-up study","volume":"65","author":"B Gonzales-Virla","year":"2019","journal-title":"Endocrine"},{"issue":"04","key":"ref36","first-page":"476","article-title":"Stereotactic radiation therapy in pituitary adenomas, is it better than conventional radiation therapy?","volume":"13","author":"M L Gheorghiu","year":"2017","journal-title":"Acta Endocrinol (Bucur)"},{"issue":"12","key":"ref37","doi-asserted-by":"crossref","first-page":"e4712","DOI":"10.1210\/clinem\/dgaa651","article-title":"Intensity-modulated radiotherapy for pituitary somatotroph adenomas","volume":"105","author":"X Lian","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"04","key":"ref38","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.3171\/2018.5.JNS18509","article-title":"Hypopituitarism after Gamma Knife radiosurgery for pituitary adenomas: a multicenter, international study","volume":"131","author":"D Cordeiro","year":"2018","journal-title":"J Neurosurg"},{"issue":"08","key":"ref39","doi-asserted-by":"crossref","first-page":"4483","DOI":"10.1210\/jc.2005-0311","article-title":"Outcome of gamma knife radiosurgery in 82 patients with acromegaly: correlation with initial hypersecretion","volume":"90","author":"F Castinetti","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"issue":"01","key":"ref40","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1093\/ejendo\/lvae003","article-title":"Efficacy of cabergoline in non-irradiated patients with acromegaly: a multi-centre cohort study","volume":"190","author":"S A Urwyler","year":"2024","journal-title":"Eur J Endocrinol"},{"issue":"03","key":"ref41","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s11102-018-0867-5","article-title":"Biochemical efficacy of long-acting lanreotide depot\/Autogel in patients with acromegaly na\u00efve to somatostatin-receptor ligands: analysis of three multicenter clinical trials","volume":"21","author":"H Alquraini","year":"2018","journal-title":"Pituitary"}],"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2693-1815.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T22:34:38Z","timestamp":1783118078000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2693-1815"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":41,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2026,7,3]]},"published-print":{"date-parts":[[2026,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2693-1815","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"value":"2193-6331","type":"print"},{"value":"2193-634X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,9]]}}}