{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T10:39:34Z","timestamp":1759401574948,"version":"3.37.3"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T00:00:00Z","timestamp":1540857600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Transsphenoidal surgery (TSS) remains the recommended primary treatment for acromegaly. Long\u2010term outcome data are not available for patients treated with gamma knife radiosurgery (STRS) as a primary treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study. Data collection: notes review, laboratory results, general physician notes, patient questionnaire and death certification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Twenty acromegaly patients underwent primary STRS at the National Centre for Radiosurgery, Sheffield, UK, between 1985 and 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Biochemical control (GH\/IGF1), hypopituitarism, morbidity and mortality were all recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 20\u00a0years of follow\u2010up, control was seen in all on acromegaly\u2010specific medication (n\u00a0=\u00a012) and 75% of those off medication (3\/4). Time for 50% to achieve control on medication was 3\u00a0years, and 7.4\u00a0years off medication. Median marginal radiation dose was 27.5\u00a0Gy, and median follow\u2010up was 166.5\u00a0months. 53% of patients developed new hypopituitarism at a median follow\u2010up of 146\u00a0months, and the development of first onset of hypopituitarism occurred as late as 20\u00a0years after treatment. With MRI planning, no other complications were noted. Three patients underwent subsequent TSS due to poor biochemical control. During follow\u2010up, 7 patients died at a median age of 65\u00a0years. There were no STRS\u2010related deaths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the longest follow\u2010up of patients who have undergone primary STRS for acromegaly. It shows low morbidity, but significant latency to biochemical control and new\u2010onset hypopituitarism. This mandates very long\u2010term follow\u2010up for these patients. STRS has shown good long\u2010term efficacy providing initial control can be afforded by optimal medical management. While TSS remains best practice, STRS offers an alternative for those in whom surgery is not an option.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13870","type":"journal-article","created":{"date-parts":[[2018,10,6]],"date-time":"2018-10-06T02:48:34Z","timestamp":1538794114000},"page":"114-121","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Radiosurgery as primary management for acromegaly"],"prefix":"10.1111","volume":"90","author":[{"given":"Hugh P.","family":"Sims\u2010Williams","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Royal Hallamshire Hospital Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9568-3398","authenticated-orcid":false,"given":"Kaveesha","family":"Rajapaksa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Royal Hallamshire Hospital Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurabh","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Royal Hallamshire Hospital Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Radatz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Royal Hallamshire Hospital Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"},{"name":"National Centre for Stereotactic Radiosurgery (STRS) Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee","family":"Walton","sequence":"additional","affiliation":[{"name":"National Centre for Stereotactic Radiosurgery (STRS) Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Yianni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Royal Hallamshire Hospital Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"},{"name":"National Centre for Stereotactic Radiosurgery (STRS) Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Newell\u2010Price","sequence":"additional","affiliation":[{"name":"Academic Unit of Diabetes, Endocrinology &amp; Metabolism, Medical School University of Sheffield Sheffield UK"},{"name":"Department of Endocrinology, Royal Hallamshire Hospital Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,30]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2700"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-2772"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19699"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.02186"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1259\/0007-1285-60-717-897"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.74.11.1536"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-012-0862-z"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-014-0578-5"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2006.02513.x"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-007-0078-y"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1616"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2009.03589.x"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0135"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2007.106.5.833"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12938"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.1677\/ERC-08-0231"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-3743"},{"key":"e_1_2_4_19_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/342034"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcen.13870","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.13870","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T18:34:13Z","timestamp":1694802853000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.13870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,30]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1111\/cen.13870"],"URL":"https:\/\/doi.org\/10.1111\/cen.13870","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"type":"print","value":"0300-0664"},{"type":"electronic","value":"1365-2265"}],"subject":[],"published":{"date-parts":[[2018,10,30]]},"assertion":[{"value":"2018-08-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}