{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T09:07:28Z","timestamp":1792919248847,"version":"4.5.0"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Stereotactic radiosurgery (SRS) is used for the treatment of residual\/recurrent nonfunctional pituitary adenoma (NFPA). The aim of this study was to evaluate the factors related to long-term tumor control and delayed endocrinopathies following SRS.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This retrospective, multicenter study included patients with recurrent\/residual NFPA treated with single-fraction SRS; they were then divided into two arms. The first arm included patients with at least 5 years of radiographic follow-up and all patients with local tumor progression. The second arm included patients with at least 5 years of endocrinological follow-up and all patients who developed endocrinopathy. Study endpoints were tumor control and new or worsening hypopituitarism after SRS and were analyzed using Cox regression and Kaplan-Meier methodology.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>There were 360 patients in the tumor control arm (median age 52.7 [IQR 42.9\u201361] years, 193 [53.6%] males) and 351 patients in the hypopituitarism arm (median age 52.5 [IQR 43\u201361] years, 186 [53.0%] males). The median follow-up in the tumor control evaluation group was 7.95 (IQR 5.7\u201310.5) years. Tumor control rates at 5, 8, 10, and 15 years were 93% (95% CI 90%\u201395%), 87% (95% CI 83%\u201391%), 86% (95% CI 82%\u201390%), and 69% (95% CI 59%\u201381%), respectively. The median follow-up in the endocrinopathy evaluation group was 8 (IQR 5.9\u201310.7) years. Pituitary function preservation rates at 5, 8, 10, and 15 years were 83% (95% CI 80%\u201387%), 81% (95% CI 77%\u201385%), 78% (95% CI 74%\u201383%), and 71% (95% CI 63%\u201379%), respectively. A margin dose &gt; 15 Gy (HR 0.8, 95% CI 0.7\u20130.9; p &lt; 0.001) and a delay from last resection to SRS &gt; 1 year (HR 0.9, 95% CI 0.7\u20130.9; p = 0.04) were significant factors related to tumor control in multivariable analysis. A maximum dose to the pituitary stalk \u2264 10 Gy (HR 1.1, 95% CI 1.09\u20131.2; p &lt; 0.001) was associated with pituitary function preservation. New visual deficits after SRS occurred in 7 (1.94%) patients in the tumor control group and 8 (2.3%) patients in the endocrinopathy group. Other new cranial nerve deficits post-SRS occurred in 4 of 160 patients with data in the tumor control group and 3 of 140 patients with data in the endocrinopathy group.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>SRS affords favorable and durable tumor control for the vast majority of NFPAs. Post-SRS hypopituitarism occurs in a minority of patients, but this risk increases with time and warrants long-term follow-up.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.1.jns232285","type":"journal-article","created":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T01:30:46Z","timestamp":1711157446000},"page":"773-780","source":"Crossref","is-referenced-by-count":10,"title":["Long-term radiographic and endocrinological outcomes of stereotactic radiosurgery for recurrent or residual nonfunctioning pituitary adenomas"],"prefix":"10.3171","volume":"141","author":[{"given":"Ahmed","family":"Shaaban","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chlo\u00e9","family":"Dumot","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"},{"name":"Department of Neurological Surgery, Hospices Civils de Lyon, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Mantziaris","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Dayawansa","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selcuk","family":"Peker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ko\u00e7 University School of Medicine, Istanbul, Turkey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yavuz","family":"Samanci","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ko\u00e7 University School of Medicine, Istanbul, Turkey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Nabeel","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt;"},{"name":"Neurosurgery Department, Faculty of Medecine, Benha University, Qalubya, Egypt;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael A.","family":"Reda","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt;"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameh R.","family":"Tawadros","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt;"},{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Abdel Karim","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt;"},{"name":"Clinical Oncology, Ain Shams University, Cairo, Egypt;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr M. 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