Evidence map›Paper›PMID 37908695›Full record

ArticleCureus2023

Promising Outcomes in Acromegaly Patients Receiving CyberKnife Stereotactic Hypofractionated Radiotherapy.

Rasim Meral, Ozlem S Selcukbiricik, Ayse K Uzum, Serdar Sahin, Murat Okutan, Mehmet Barburoglu, Ilyas Dolas, Musa Altun, Sema Yarman, Pinar Kadıoglu

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 24% of its field
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
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

10 authors at 2 institutions in 1 country.

Rasim MeralDepartment of Clinical Oncology, Istanbul University Institute of Oncology, Istanbul, TUR.
Ozlem S SelcukbiricikDepartment of Endocrinology, Istanbul University School of Medicine, Istanbul, TUR.
Ayse K UzumDepartment of Endocrinology, Istanbul University School of Medicine, Istanbul, TUR.
Serdar SahinDepartment of Endocrinology, Istanbul University - Cerrahpasa School of Medicine, Istanbul, TUR.
Murat OkutanDepartment of Medical Physics, Istanbul University Institute of Oncology, Istanbul, TUR.
Mehmet BarburogluDepartment of Radiology, Istanbul University School of Medicine, Istanbul, TUR.
Ilyas DolasDepartment of Neurological Surgery, Istanbul University School of Medicine, Istanbul, TUR.
Musa AltunDepartment of Radiation Oncology, Istanbul University School of Medicine, Istanbul, TUR.
Sema YarmanDepartment of Endocrinology, Istanbul University School of Medicine, Istanbul, TUR.
Pinar KadıogluDepartment of Endocrinology, Istanbul University - Cerrahpasa School of Medicine, Istanbul, TUR.
Istanbul University · TRIstanbul University-Cerrahpaşa · TR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe primary treatment for patients with acromegaly has traditionally been transsphenoidal surgery, with decreasing reliance on radiotherapy (RT) due to advancements in pharmacotherapy (PT). Despite these advancements, a substantial portion of patients still face persistent acromegaly, necessitating novel treatment approaches. This study investigates the role of CyberKnife Stereotactic Hypofractionated Radiotherapy (CK-HFRT) in persistent acromegaly.

objectiveThe primary objective was to assess the impact of CK-HFRT on endocrine remission (ER) rates while maintaining acceptable toxicity levels.

methodsThe study retrospectively analyzed 31 consecutive patients with acromegaly who received CK-HFRT following multiple unsuccessful surgeries and prolonged PT without ER. Various CK-HFRT dose fractionation regimes were administered, and dose volume histograms were evaluated. Tumor control, cured disease (CD), endocrine remission (ER) rates, and overall survival were estimated at a median follow-up of 62 months. Acute and late toxicity, including pituitary insufficiency and radiation-induced optic neuropathy (RION), were also assessed.

resultsAt 62 months of follow-up, the study group demonstrated excellent tumor control with 100% nonprogressive adenomas. Endocrine remission was achieved in 86.7% of patients, with a 22.4% CD rate at five years. Pituitary insufficiency occurred in 32.3% of patients, and no cases of RION were reported. The study observed three deaths related to cardiovascular diseases, all in patients receiving PT. Overall survival at five years was 79.2%.

conclusionCyberKnife stereotactic hypofractionated radiotherapy, as an adjunct to PT, provides a viable treatment option for patients with persistent acromegaly following unsuccessful surgeries. The therapy results in substantial ER rates and tumor control while minimizing the risk of permanent radiation-induced optic neuropathy. However, the decision to administer CK-HFRT should be individualized, considering the patient's overall condition and treatment history.

Indexed as

acromegalycyberknife stereotactic hypofractionated radiotherapyendocrine remissionpituitary adenomapituitary insufficiencyradiation induced optic neuropathy

Identifiers

PMID37908695
PMCPMC10613787
OpenAlexW4388102509

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.