{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:06:41Z","timestamp":1780628801360,"version":"3.54.1"},"reference-count":32,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T00:00:00Z","timestamp":1677196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Mexican Institute of Social Security"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objective: To analyze, in a cohort of acromegalic patients, the results of the efficiency and safety of radiosurgery (CyberKnife), as well as the prognostic factors associated with disease remission. Material and methods: Observational, retrospective, longitudinal, and analytical study that included acromegalic patients with persistent biochemical activity after initial medical\u2013surgical treatment, who received treatment with CyberKnife radiosurgery. GH and IGF-1 levels at baseline after one year and at the end of follow-up were evaluated. Results: 57 patients were included, with a median follow-up of four years (IQR, 2\u20137.2 years). The biochemical remission rate was 45.6%, 33.33% achieved biochemical control, and 12.28% attained biochemical cure at the end of follow-up. A progressive and statistically significant decrease was observed in the comparison of the concentrations of IGF-1, IFG-1 x ULN, and baseline GH at one year and at the end of follow-up. Both cavernous sinus invasion and elevated baseline IGF-1 x ULN concentrations were associated with an increased risk of biochemical non-remission. Conclusion: Radiosurgery (CyberKnife) is a safe and effective technique in the adjuvant treatment of GH-producing tumors. Elevated levels of IGF x ULN before radiosurgery and invasion of the cavernous sinus by the tumor could be predictors of biochemical non-remission of acromegaly.<\/jats:p>","DOI":"10.3390\/cancers15051438","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T01:37:52Z","timestamp":1677202672000},"page":"1438","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Efficiency and Safety of CyberKnife Robotic Radiosurgery in the Multimodal Management of Patients with Acromegaly"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1175-3959","authenticated-orcid":false,"given":"Carlos Alfonso","family":"Romero-Gameros","sequence":"first","affiliation":[{"name":"Otorhinolaryngology Service, Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6924-2209","authenticated-orcid":false,"given":"Baldomero","family":"Gonz\u00e1lez-Virla","sequence":"additional","affiliation":[{"name":"Endocrinology Service, Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guadalupe","family":"Vargas-Ortega","sequence":"additional","affiliation":[{"name":"Endocrinology Service, Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Sosa-Eroza","sequence":"additional","affiliation":[{"name":"Endocrinology Service, Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7310-6656","authenticated-orcid":false,"given":"Mario Enrique","family":"Rend\u00f3n-Mac\u00edas","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Faculty of Health Sciences, Universidad Panamericana, Mexico City 03920, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0373-6641","authenticated-orcid":false,"given":"Lourdes Josefina","family":"Balc\u00e1zar-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Endocrinology Service, Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4748-9734","authenticated-orcid":false,"given":"Moises","family":"Mercado","sequence":"additional","affiliation":[{"name":"Medical Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro M\u00e9dico Nacional SigloXXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Novelthys","family":"Velasco-Cortes","sequence":"additional","affiliation":[{"name":"Robotic Radiosurgery Service, Hospital de Oncolog\u00eda, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Aaron","family":"Rodea-\u00c1vila","sequence":"additional","affiliation":[{"name":"Robotic Radiosurgery Service, Hospital de Oncolog\u00eda, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Flores-Robles","sequence":"additional","affiliation":[{"name":"Robotic Radiosurgery Service, Hospital de Oncolog\u00eda, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Armando","family":"Lorenzana-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Endocrinology Service, Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"V\u00e1zquez-Rojas","sequence":"additional","affiliation":[{"name":"Endocrinology Service, Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"L\u00f3pez-Palma","sequence":"additional","affiliation":[{"name":"Endocrinology Service, Hospital de Especialidades, Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro 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