Long-term outcomes of hypopituitarism following gamma knife radiosurgery for pituitary adenomas | ||||
| International Journal of Medical Arts | ||||
| Article 13, Volume 7, Issue 7, July 2025, Page 5903-5908 PDF (1.52 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ijma.2025.390609.2194 | ||||
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| Authors | ||||
Ahmed M. Taha  1; Awad Hegab2; Shaimaa Ahmed Dahshan3
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| 1Department of Neurosurgery, Faculty of medicine, Al-Azhar university, Damietta, Egypt. | ||||
| 2Department of Neurosurgery, Faculty of medicine, Al-Azhar university, Damietta, Egypt | ||||
| 3Department Anesthesia, Faculty of Medicine, Seuz Canal University, Ismailia, Egypt. | ||||
| Abstract | ||||
| Background: Gamma knife radiosurgery (GKRS) is an established treatment for pituitary adenomas (PAs), particularly for recurrent or residual tumors following surgical resection. However, hypopituitarism remains a significant complication. This study evaluated the long-term outcomes of hypopituitarism following GKRS for PAs. Methods: This prospective study included 137 adult patients who underwent GKRS for PAs. Comprehensive endocrine evaluations were performed before and after treatment, including measurement of thyroid, adrenal, gonadal, and growth hormone function. Tumor volumes were calculated using standardized magnetic resonance imaging protocols, and tumor response was categorized as progression, shrinkage, or stable based on volumetric changes. Results: Post-GKRS, significant reductions were observed in thyroid-stimulating hormone, cortisol, prolactin, growth hormone, and insulin-like growth factor-1 levels (p<0.001), while free triiodothyronine and thyroxine levels increased significantly (p<0.001). Hypothyroidism was diagnosed in 58.39% of patients post-treatment compared to 73.72% pre-treatment. New-onset hypopituitarism occurred in 13.14% of patients post-treatment, significantly lower than the pretreatment rate of 36.5% (p<0.001). Tumor progression occurred in 8.03% of cases. Larger tumor volume (OR=1.42, 95%CI:1.154-1.74) and tumor progression (OR=0.210, 95%CI:0.093-0.473) were independent predictors of hypothyroidism. Conclusions: GKRS effectively controls PAs but carries a significant risk of endocrine dysfunction. Tumor volume and progression are independent predictors of post-GKRS hypothyroidism, emphasizing the need for long-term endocrine monitoring in these patients. Additionally, new-onset hypopituitarism significantly decreased post-GKRS, underscoring the importance of comprehensive pituitary function assessment following treatment | ||||
| Keywords | ||||
| Gamma knife radiosurgery; pituitary adenoma; hypopituitarism; hypothyroidism; tumor volume | ||||
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