Evidence map›Paper›PMID 32506372›Full record

SynthesisJournal of neuro-oncology2020

Stereotactic radiosurgery for acromegaly: an international systematic review and meta-analysis of clinical outcomes.

Raj Singh, Prabhanjan Didwania, Eric J Lehrer, Darrah Sheehan, Kimball Sheehan, Daniel M Trifiletti, Jason P Sheehan

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of neuro-oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Current treatment landscape of acromegaly.The Journal of clinical endocrinology and metabolism · 2026
    Review
  5. [Efficacy of octreotide LAR and lanreotide autogel in acromegaly assessed by SAGIT].Revista medica del Instituto Mexicano del Seguro Social · 2026
    Observational
  6. Article
  7. Article
  8. Acromegaly: diagnostic challenges and individualized treatment.Expert review of endocrinology & metabolism · 2025
    Review
  9. Article
  10. Article
  11. Review
  12. Review
  13. Novel therapies for acromegaly.Endocrine connections · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Raj SinghDepartment of Radiation Oncology, Virginia Commonwealth University Health System, Richmond, VA, USA.
Prabhanjan DidwaniaRady School of Management, University of California at San Diego, San Diego, CA, USA.
Eric J LehrerDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Darrah SheehanDepartment of Neurosurgery, University of Virginia, School of Medicine, Box 800212, Charlottesville, VA, 22903, USA.
Kimball SheehanDepartment of Neurosurgery, University of Virginia, School of Medicine, Box 800212, Charlottesville, VA, 22903, USA.
Daniel M TrifilettiDepartment of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA.
Jason P SheehanDepartment of Neurosurgery, University of Virginia, School of Medicine, Box 800212, Charlottesville, VA, 22903, USA. jps2f@virginia.edu.ORCID http://orcid.org/0000-0002-0025-9886

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWe performed a systematic review and meta-analysis of clinical outcomes for patients with acromegaly treated with stereotactic radiosurgery (SRS).

methodsPrimary outcomes were 5- and 10-year endocrine remission (ER) and endocrine control (EC). Secondary outcomes were 10-year radiographic local control (LC), visual toxicity, and hypopituitarism rates. Weighted random effects meta-analyses using the DerSimonian and Laird methods were conducted to characterize and compare effect sizes. Mixed effects regression models were used to examine correlations between potential prognostic factors and primary and secondary outcomes.

resultsIn total, 1533 patients across 20 published studies with acromegaly treated with SRS were included. At 5-years, estimated ER and EC rates were 43.2% (95% CI 31.7-54.6%) and 55.0% (95% CI 27.6-82.4%), respectively. At 10-years, estimated ER and EC rates were 56.9% (95% CI 47.5-66.4%) and 69.7% (95% CI 47.7-91.8%), respectively. The estimated 10-year LC rate was 92.8% (95% CI 83.0-100%). Visual toxicity and hypopituitarism following SRS were estimated to be 2.7% (95% CI 1.3-4.2%) and 26.8% (95% CI 16.9-36.7%), respectively. Every 1 Gy increase in margin prescription dose beyond 17 Gy was estimated to result in a 0.41% increased risk of visual toxicity (p = 0.03). No prognostic factors were associated with EC, ER, LC, or hypopituitarism.

conclusionsSRS was well-tolerated in the management of pituitary acromegaly resulting in gradually improving ER and EC rates over time that approached 60% and 70%. SRS-related visual loss is an uncommon treatment-related side effect, and patient-specific clinical decision making remains critical.

Indexed as

AcromegalyHumansInternational AgenciesRadiosurgeryTreatment OutcomeAcromegalyBiochemical controlLocal controlMeta-analysisSRSStereotactic radiosurgeryToxicity

Identifiers

PMID32506372

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.