Evidence map›Paper›PMID 40111591›Full record

ArticleJournal of endocrinological investigation2025

Repeat gamma knife radiosurgery for recurrent pituitary adenomas.

Marco Losa, Luigi Albano, Elena Prandino, Enrico Garbin, Antonella Del Vecchio, Andrei Fodor, Nadia Di Muzio, Lina Raffaella Barzaghi, Pietro Mortini

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In one paragraph

Article in Journal of endocrinological investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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

  1. Pooled it
  2. 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

9 authors.

Marco LosaDepartment of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. losa.marco@hsr.it.ORCID http://orcid.org/0000-0001-7810-8247
Luigi AlbanoDepartment of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Elena PrandinoDepartment of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Enrico GarbinDepartment of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Antonella Del VecchioDepartment of Medical Physics, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Andrei FodorDepartment of Radiation Therapy, IRCCS Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Nadia Di MuzioDepartment of Radiation Therapy, IRCCS Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Lina Raffaella BarzaghiDepartment of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Pietro MortiniDepartment of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecurrence of pituitary adenoma after Gamma Knife radiosurgery (GKRS) occurs in around 10% of cases. This study aims to evaluate the effectiveness and safety of repeat GKRS in pituitary adenoma patients who had tumor recurrence after the first GKRS.

methodsThis retrospective study included 38 consecutive patients who received a second GKRS treatment for pituitary adenoma at the same institute from 1994 to 2023. The primary study endpoint was tumor growth control. Safety assessment included neurological, visual, and endocrine function.

resultsThe median radiological follow-up was 71.5 months (IQR, 21.7-124 months). Nine patients (23.7%) had recurrence of disease. The 5-year and 10-year progression-free survival rates were 75.2% (95% CI, 58.4-92.0%) and 61.7% (95% CI, 39.3-84.1%), respectively. Adjusted Cox analysis showed that hormone-secreting adenoma (HR 6.82; 95% CI, 1.42-32.68; P 0.02), having received another surgical procedure before repeat GKRS (HR 10.63; 95% CI, 1.77-63.85; P 0.01), and the interval between the first and the second GKRS (HR 0.97; 95% CI, 0.95-0.99; P 0.01) were independently associated with the risk of tumor recurrence. No serious side effects occurred after repeat GKRS treatment, except one case of transient diplopia and trigeminal neuralgia. New thyroid, gonadal, and adrenal deficit developed in 10.5%, 7.1%, and 18.7% of patients, respectively.

conclusionRepeat GKRS for regrowth of a pituitary adenoma can stop tumor progression in most patients. No specific safety concerns emerged. Repeat GKRS can be included among the few therapeutic options available after failure of a first GKRS.

Indexed as

AdenomaNeoplasm Recurrence, LocalPituitary NeoplasmsRadiosurgeryReoperationAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesTreatment OutcomeGamma knifeHypopituitarismPituitary neoplasmRecurrenceStereotactic radiosurgery

Identifiers

PMID40111591

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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.