{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T04:41:32Z","timestamp":1769316092250,"version":"3.49.0"},"reference-count":53,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,4,12]],"date-time":"2006-04-12T00:00:00Z","timestamp":1144800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2006,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Objective\u2002<\/jats:bold> The Leksell gamma knife (LGK) is one of the treatment options for pituitary adenomas. We report on our long\u2010term experience treating acromegaly using LGK.<\/jats:p><jats:p><jats:bold>Design\u2002\u2002<\/jats:bold> Since 1993 we have followed 96 acromegaly patients through periods of from 12 to 120\u00a0months. The mean follow\u2010up period was 53\u00b77\u00a0\u00b1\u00a026\u00b78\u00a0months. Seventy\u2010two patients were treated with neurosurgery prior to LGK; for 24 LGK was the primary treatment. Thirteen patients were irradiated twice, due to persistent activity of the adenoma or its residue. Pituitary functions were tested at 6\u2010month intervals, post\u2010irradiation. The target tumour volume for radiosurgery was between 93\u00b73 and 12\u00a0700\u00a0mm<jats:sup>3<\/jats:sup> (median 1350\u00a0mm<jats:sup>3<\/jats:sup>).<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Fifty per cent of the patients achieved mean GH &lt;\u00a02\u00b75\u00a0\u00b5g\/l within 42\u00a0months, normalized their IGF\u2010I within 54\u00a0months, and achieved GH suppression in the oral glucose tolerance test (oGTT) &lt;\u00a01\u00a0\u00b5g\/l with normal IGF\u2010I within 66\u00a0months. LGK effectiveness was dependent on initial adenoma hormonal activity (GH and IGF\u2010I serum levels), not on the size of the adenoma. Patients with primary neurosurgery followed by LGK irradiation had better outcomes than those with LGK alone. Irradiation arrested all adenoma growth, causing tumour shrinkage in 62\u00b73% of patients. Twenty\u2010six developed hypopituitarism when irradiated by 15\u00a0Gy (or more) on functional peritumoral pituitary tissue. No hypopituitarism appeared using lower doses.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> In acromegaly, LGK is a useful adjunct to primary neurosurgery when treating post\u2010surgical residues because it can limit the duration of medical therapy. It can be used as a primary therapy when neurosurgery is not possible.<\/jats:p>","DOI":"10.1111\/j.1365-2265.2006.02513.x","type":"journal-article","created":{"date-parts":[[2006,4,21]],"date-time":"2006-04-21T10:31:51Z","timestamp":1145615511000},"page":"588-595","source":"Crossref","is-referenced-by-count":130,"title":["Gamma knife radiosurgery for acromegaly \u2013 long\u2010term 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