{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T13:50:07Z","timestamp":1792245007061,"version":"4.4.0"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The authors reviewed outcomes after stereotactic radiosurgery for patients with acromegaly and analyzed factors associated with biochemical remission.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Retrospective analysis was performed for 46 consecutive cases of growth hormone (GH)\u2013producing pituitary adenomas treated by radiosurgery between 1991 and 2004. Biochemical remission was defined as a fasting GH less than 2 ng\/ml and a normal age- and sex-adjusted insulin-like growth factor\u2013I (IGF-I) level while patients were not receiving any pituitary suppressive medications. The median follow up after radiosurgery was 63 months (range 22\u2013168 months).<\/jats:p>\n<jats:p>Twenty-three patients (50%) had biochemical remission documented at a median of 36 months (range 6\u201363 months) after one radiosurgical procedure. The actuarial rates of biochemical remission at 2 and 5 years after radiosurgery were 11 and 60%, respectively. Multivariate analysis showed that IGF-I levels less than 2.25 times the upper limit of normal (hazard ratio [HR] 2.9, 95% confidence interval [CI] 1.2\u20136.9, p = 0.02) and the absence of pituitary suppressive medications at the time of radiosurgery (HR 4.2, 95% CI 1.4\u201313.2, p = 0.01) correlated with biochemical remission. The incidence of new anterior pituitary deficits was 10% at 2 years and 33% at 5 years.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Discontinuation of pituitary suppressive medications at least 1 month before radiosurgery significantly improved endocrine outcomes for patients with acromegaly. Patients with GH\u2013producing pituitary adenomas should not undergo further radiation therapy or surgery for at least 5 years after radiosurgery because GH and IGF-I levels continue to normalize over that interval.<\/jats:p><\/jats:sec>","DOI":"10.3171\/jns.2007.106.5.833","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T12:46:36Z","timestamp":1201178796000},"page":"833-838","source":"Crossref","is-referenced-by-count":149,"title":["Radiosurgery of growth hormone\u2013producing pituitary adenomas: factors associated with biochemical remission"],"prefix":"10.3171","volume":"106","author":[{"given":"Bruce E.","family":"Pollock","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Radiation Oncology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Jacob","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Radiation Oncology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd B.","family":"Nippoldt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic College of Medicine, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1060833","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"3411","DOI":"10.1210\/jcem.83.10.5111","article-title":"Transsphenoidal microsurgery for growth hormone-secreting pituitary adenomas: initial outcome and long-term results","volume":"83","author":"Abosch","year":"1998"},{"key":"b2-1060833","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"111","DOI":"10.3171\/jns.1998.88.1.0111","article-title":"Multiple radiation-induced intracranial lesions after treatment for pituitary adenoma. 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