{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:21:32Z","timestamp":1755224492976,"version":"3.43.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Radiotherapy (RT) is an established second-line treatment in adult Cushing disease (CD). Data on pituitary RT in childhood and adolescent-onset CD is scarce. This study aims to demonstrate the effectiveness and long-term safety of fractionated conformal-RT (CRT) in childhood and adolescent-onset CD patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This single-center retrospective study included 34 out of 108 CD patients (&amp;lt;20 years at presentation) who underwent first-line, second-line (post-first transsphenoidal-surgery), or third-line (post-second transsphenoidal-surgery) CRT between 1994 and 2024, with a minimum 1-year follow-up post-CRT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data from 34 patients (21 males, 7 prepubertal, and 24 microadenomas) with post-CRT median follow-up of 74.5 (34.5-127.3) months were analyzed. Post-CRT, 25\/34 (73.5%) patients (overall cohort) achieved remission at 16.5 (8.75-39.25) months, with remission rates of 60%, 93.8%, and 53.8% in first, second, and third-line CRT, respectively. Younger age at CD diagnosis was an independent predictor of remission (HR: 0.805, P = .02). Relapse occurred in 6\/25 (24%) at 19.0 (18.3-30.3) months. Ketoconazole use predicted relapse post-CRT (P = .006). Growth hormone deficiency occurred in 17\/20 (85%), and 29\/34 (41.4%) patients had low insulin-like growth factor-1 levels. New-onset hypogonadotropic hypogonadism (HH) and central hypothyroidism (CHT) occurred in 3\/24 (12.5%) and 4\/24 (16.7%) patients, respectively. Older age at CD diagnosis (17.5 vs. 13.0 years; P = .02) and at CRT administration (23 vs. 14 years; P = .04) predicted new-onset HH and\/or CHT post-CRT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our study illustrates the favorable remission rates post-CRT in childhood and adolescent CD, with lower rates of new-onset HH\/CHT. Ongoing monitoring is required, as relapse can occur in one-fourth of cases.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejendo\/lvaf149","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T18:01:08Z","timestamp":1753380068000},"page":"223-231","source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes of pituitary radiotherapy and their predictive factors in childhood and adolescent-onset Cushing disease"],"prefix":"10.1093","volume":"193","author":[{"given":"Raghavendra","family":"Pandit","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Seth GS Medical College and KEM Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chethan Yami","family":"Channaiah","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Seth GS Medical College and KEM Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9623-4471","authenticated-orcid":false,"given":"Anurag Ranjan","family":"Lila","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Seth GS Medical College and KEM Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7277-7052","authenticated-orcid":false,"given":"Manjiri","family":"Karlekar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Seth GS Medical College and KEM Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0243-0448","authenticated-orcid":false,"given":"Vijaya","family":"Sarathi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Vydehi Institute of Medical Sciences , Bengaluru, Karnataka 560066 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saba Samad","family":"Memon","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Seth GS Medical College and KEM Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Barnabas","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Seth GS Medical College and KEM Hospital , Mumbai, Maharashtra 400012 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tejpal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, ACTREC, Tata Memorial Centre, HBNI, Kharghar , Navi Mumbai, Maharashtra 410210 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