ArticleCureus2025
Stereotactic Radiosurgery and Fractionated Stereotactic Radiotherapy With a Linear Accelerator (LINAC) for Acromegaly Remission: Clinical Experience From a Tertiary Neurological Center in Latin America.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
Background and objective Fractionated stereotactic radiotherapy (FSRT) and stereotactic radiosurgery (SRS) are commonly used in patients with growth hormone (GH)-secreting pituitary adenomas (PAs) who are not candidates for surgery, have residual disease postoperatively, or have failed or cannot access medical therapy. It is also considered a first-line option in elderly patients or those with comorbidities that contraindicate surgery. In this study, we aimed to evaluate the long-term outcomes of SRS and FSRT in patients with acromegaly who remained biochemically active despite prior surgical and/or medical treatment. Methods This was an observational, analytical, longitudinal, and retrospective study with an 11-year follow-up. Patients were divided into two groups according to the radiotherapy modality (SRS or FSRT, both delivered via a linear accelerator (LINAC)). Outcome measures included biochemical remission, hypopituitarism, and visual function. Results A total of 140 patients were included; 105 patients received SRS and 35 received FSRT between 2004 and 2015. Among SRS-treated patients, 41.11% (n=43) achieved biochemical remission at three years. In the FSRT group, no complete biochemical remissions were achieved at six years of follow-up. Conclusions Stereotactic radiotherapy is an effective adjuvant treatment for acromegaly. SRS demonstrated progressive biochemical remission with acceptable long-term toxicity. FSRT remains a therapeutic alternative when SRS is not feasible. These findings, from a Latin American public neurosurgical center, endorse the feasibility of implementing stereotactic techniques in resource-limited settings.
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