{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T08:38:34Z","timestamp":1742805514785,"version":"3.37.3"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,7,4]],"date-time":"2021-07-04T00:00:00Z","timestamp":1625356800000},"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":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Gamma knife radiosurgery (GKRS) has proven to be an effective adjuvant treatment for patients with acromegaly. We performed the present study to investigate, which would be the outcome of GKRS, independently on the response to somatostatin receptor ligand (SRL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective, observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Ninety\u2010six patients with active acromegaly were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The cumulative probability of normalisation of insulin\u2010like growth factor 1 (IGF\u20101) levels after GKRS was assessed by the Kaplan\u2013Meier method. The association of several clinical characteristics with GKRS outcomes was explored with the use of a Cox proportional\u2010hazard model with the relative hazard ratio\u00a0and 95% confidence interval (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Resistance to SRL\u00a0occurred in 39 of the 96 patients (40.6%). After GKRS, patients resistant to SRL had a 5\u2010 and 10\u2010year probability of remission of 40.7% (95% CI: 23.7%\u201357.7%) and 75.9% (95% CI: 57.9%\u201393.9%), respectively. Patients responding to SRL had a 5\u2010 and 10\u2010year probability of remission of 46.8% (95% CI: 32.2%\u201361.4%) and 58.1% (95% CI: 41.5%\u201374.7%), respectively. The difference was not significant (<jats:italic>p<\/jats:italic>\u2009=\u2009.48 by the log\u2010rank test). Multivariate Cox analysis confirmed that the only independent variables associated with GKRS outcome were basal growth hormone (GH; <jats:italic>p<\/jats:italic>\u2009=\u2009.001) and IGF\u20101 multiple of the upper limit of normal levels before GKRS (<jats:italic>p<\/jats:italic>\u2009=\u2009.013).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We demonstrate for the first time that the responsiveness to SRL has no effect on the probability to obtain remission of acromegaly after GKRS. The remission of disease occurred more frequently in patients who had lower GH and IGF\u20101 levels before GKRS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14547","type":"journal-article","created":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T05:06:36Z","timestamp":1625461596000},"page":"849-855","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Resistance to first\u2010generation somatostatin receptor ligands does not impair the results of gamma knife radiosurgery in acromegaly"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7810-8247","authenticated-orcid":false,"given":"Marco","family":"Losa","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7919-4316","authenticated-orcid":false,"given":"Eugenia","family":"Resmini","sequence":"additional","affiliation":[{"name":"Endocrinology Department, Hospital Sant Pau, Centro de Investigaci\u00f3n Biom\u00e9dica en Enfermedades Raras (CIBERER 747), ISCIII, Biomedical Research Institute Sant Pau (IIB Sant Pau) Universitat Autonoma de Barcelona (UAB)  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina R.","family":"Barzaghi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Albano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan 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