TY - JOUR
T1 - Outcomes of stereotactic radiosurgery for pituitary metastases
T2 - an international multi-institutional study
AU - Abou-Al-Shaar, Hussam
AU - Albalkhi, Ibrahem
AU - Shariff, Rimsha K.
AU - Mallela, Arka N.
AU - Fazeli, Pouneh K.
AU - Tos, Salem M.
AU - Mantziaris, Georgios
AU - Meng, Ying
AU - Bernstein, Kenneth
AU - Kaisman-Elbaz, Tehila
AU - Abofani, Hanan
AU - Lin, Yen Yu
AU - Lee, Cheng Chia
AU - Tripathi, Manjul
AU - Upadhyay, Rituraj
AU - Palmer, Joshua D.
AU - Nabeel, Ahmed M.
AU - Reda, Wael A.
AU - Tawadros, Sameh R.
AU - Abdelkarim, Khaled
AU - El-Shehaby, Amr M.N.
AU - Emad, Reem M.
AU - Peker, Selcuk
AU - Samanci, Yavuz
AU - Wegner, Rodney E.
AU - Shepard, Matthew J.
AU - Liscak, Roman
AU - Simonova, Gabriela
AU - Almeida, Timoteo
AU - Benjamin, Carolina
AU - Kondziolka, Douglas
AU - Sheehan, Jason P.
AU - Niranjan, Ajay
AU - Hadjipanayis, Constantinos G.
AU - Lunsford, L. Dade
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.
PY - 2025/6/1
Y1 - 2025/6/1
N2 - Background: Pituitary metastases (PM) account for 0.4% of all intracranial metastases and typically present with visual and endocrinological deficits. Stereotactic radiosurgery (SRS) has shown excellent tumor control and safety profile in the management of intracranial metastases. However, its role and safety in managing metastases to the pituitary gland are not well-characterized. This study aims to evaluate SRS outcomes and safety profile in the management of PM in a multicenter international cohort. Methods: The authors retrospectively analyzed data from 63 patients with PM treated with SRS across 12 institutions, assessing clinical and radiological outcomes, including survival rates, tumor control, visual and endocrinological outcomes, and post-treatment complications. Results: Among 63 patients included in the study (median tumor volume: 1.5 cc), SRS demonstrated a local tumor control rate of 93.1% at 12 months. The median survival was 25.4 months and overall survival rates of 77.6%, 65.9%, and 55.1% at 6, 12, and 18 months, respectively. In multivariate analysis, a margin dose for PM > 10 Gy emerged as an independent predictor across progression-free survival (HR: 0.20, p < 0.01), distant metastasis-free survival (HR: 0.30, p = 0.01), and overall survival. (HR: 0.15, p < 0.01). Following SRS, most patients showed stable or improved visual function (n = 17/18). A small percentage of patients experienced complications: developed new visual deficits (n = 1/63), experienced new anterior pituitary hormone deficiency (n = 5/63), and developed arginine vasopressin (AVP)-deficiency post-treatment (n = 2/63). Conclusion: SRS is an important modality in the management of PM, offering excellent local tumor control and survival outcomes with minimal morbidity. These findings support the incorporation of SRS into the multidisciplinary management for treating patients with PM.
AB - Background: Pituitary metastases (PM) account for 0.4% of all intracranial metastases and typically present with visual and endocrinological deficits. Stereotactic radiosurgery (SRS) has shown excellent tumor control and safety profile in the management of intracranial metastases. However, its role and safety in managing metastases to the pituitary gland are not well-characterized. This study aims to evaluate SRS outcomes and safety profile in the management of PM in a multicenter international cohort. Methods: The authors retrospectively analyzed data from 63 patients with PM treated with SRS across 12 institutions, assessing clinical and radiological outcomes, including survival rates, tumor control, visual and endocrinological outcomes, and post-treatment complications. Results: Among 63 patients included in the study (median tumor volume: 1.5 cc), SRS demonstrated a local tumor control rate of 93.1% at 12 months. The median survival was 25.4 months and overall survival rates of 77.6%, 65.9%, and 55.1% at 6, 12, and 18 months, respectively. In multivariate analysis, a margin dose for PM > 10 Gy emerged as an independent predictor across progression-free survival (HR: 0.20, p < 0.01), distant metastasis-free survival (HR: 0.30, p = 0.01), and overall survival. (HR: 0.15, p < 0.01). Following SRS, most patients showed stable or improved visual function (n = 17/18). A small percentage of patients experienced complications: developed new visual deficits (n = 1/63), experienced new anterior pituitary hormone deficiency (n = 5/63), and developed arginine vasopressin (AVP)-deficiency post-treatment (n = 2/63). Conclusion: SRS is an important modality in the management of PM, offering excellent local tumor control and survival outcomes with minimal morbidity. These findings support the incorporation of SRS into the multidisciplinary management for treating patients with PM.
KW - Metastases
KW - Pituitary neoplasms, hormonal outcomes
KW - Progression-Free survival
KW - Stereotactic radiosurgery
KW - Survival analysis
KW - Vision
UR - https://www.scopus.com/pages/publications/105006900146
U2 - 10.1007/s11102-025-01542-z
DO - 10.1007/s11102-025-01542-z
M3 - Article
C2 - 40442537
AN - SCOPUS:105006900146
SN - 1386-341X
VL - 28
JO - Pituitary
JF - Pituitary
IS - 3
M1 - 69
ER -