Review
Clinical Neurology
David Mathieu, Rupesh Kotecha, Arjun Sahgal, Antonio De Salles, Laura Fariselli, Bruce E. Pollock, Marc Levivier, Lijun Ma, Ian Paddick, Jean Regis, Shoji Yomo, John H. Suh, Muni Rubens, Jason P. Sheehan
Summary: Stereotactic radiosurgery (SRS) provides effective tumor control for secretory pituitary adenomas, but has a lower rate of endocrine improvement or remission.
JOURNAL OF NEUROSURGERY
(2022)
Article
Neurosciences
Eric J. Lehrer, Roman O. Kowalchuk, Daniel M. Trifiletti, Jason P. Sheehan
Summary: Pituitary adenomas are common benign brain tumors, comprising 10%-20% of all central nervous system neoplasms. Stereotactic radiosurgery (SRS) has emerged as an effective treatment option for these tumors, with high tumor control rates. However, potential side effects such as endocrine dysfunction and visual deficits need to be considered. Hypofractionated SRS, delivered in multiple fractions, is an alternative treatment option for patients who are not suitable for single fraction SRS.
Article
Clinical Neurology
I. Jonathan Pomeraniec, Zhiyuan Xu, Cheng-Chia Lee, Huai-Che Yang, Tomas Chytka, Roman Liscak, Roberto Martinez-Alvarez, Nuria Martinez-Moreno, Luca Attuati, Piero Picozzi, Douglas Kondziolka, Monica Mureb, Kenneth Bernstein, David Mathieu, Michel Maillet, Akiyoshi Ogino, Hao Long, Hideyuki Kano, L. Dade Lunsford, Brad E. Zacharia, Christine Mau, Leonard C. Tuanquin, Christopher Cifarelli, David Arsanious, Joshua Hack, Ronald E. Warnick, Ben A. Strickland, Gabriel Zada, Eric L. Chang, Herwin Speckter, Samir Patel, Dale Ding, Darrah Sheehan, Kimball Sheehan, Svetlana Kvint, Love Y. Buch, Alexander R. Haber, Jacob Shteinhart, Mary Lee Vance, Jason P. Sheehan
Summary: Stereotactic radiosurgery (SRS) is an effective treatment for pituitary adenomas, but the mechanism of delayed endocrine deficits is not well understood. This multicenter study aimed to evaluate radiation tolerance and identify predictors of delayed hypopituitarism after SRS for these tumors. The study found that tumor control was achieved in a high percentage of patients, but a significant number developed new loss of pituitary function, with certain factors such as tumor type, age, and radiation dose playing a role.
JOURNAL OF NEUROSURGERY
(2022)
Article
Oncology
Natasha Ironside, Harrison Snyder, Zhiyuan Xu, David Schlesinger, Ching-Jen Chen, Mary Lee Vance, Gregory K. Hong, John A. Jane, Jason P. Sheehan
Summary: This study investigated the relationship between the distance from the hypothalamic-pituitary axis to the treatment target and anterior pituitary function preservation after stereotactic radiosurgery (SRS) for pituitary adenomas. The results showed that a greater distance between the normal pituitary gland and the SRS target was associated with anterior pituitary function preservation.
JOURNAL OF NEURO-ONCOLOGY
(2022)
Article
Oncology
Junyi Fu, Yanli Li, Lisha Wu, Xin Yang, Tingting Quan, Xi Li, Jiamin Zeng, Yinhui Deng, Jinxiu Yu
Summary: This study aimed to investigate the incidence, risk factors, and prognosis of pituitary hemorrhage in pituitary adenomas treated with gamma knife radiosurgery. It was found that nonfunctioning pituitary adenomas were an independent risk factor for new or worsened pituitary hemorrhage after gamma knife radiosurgery.
Review
Oncology
Jeremiah Hilkiah Wijaya, Yang Yang Endro Arjuna, Julius July
Summary: This systematic review examined the role of stereotactic radiosurgery (SRS) in treating petroclival meningioma (PM) cases. The study found that SRS was effective in controlling tumor progression with a low complication rate.
JOURNAL OF NEURO-ONCOLOGY
(2022)
Article
Clinical Neurology
Georgios Mantziaris, Stylianos Pikis, Tomas Chytka, Roman Liscak, Kimball Sheehan, Darrah Sheehan, Selcuk Peker, Yavuz Samanci, Shray K. Bindal, Ajay Niranjan, L. Dade Lunsford, Rupinder Kaur, Renu Madan, Manjul Tripathi, Dhiraj J. Pangal, Ben A. Strickland, Gabriel Zada, Anne-Marie Langlois, David Mathieu, Ronald E. Warnick, Samir Patel, Zayda Minier, Herwin Speckter, Zhiyuan Xu, Rithika Kormath Anand, Jason P. Sheehan
Summary: This study analyzed 375 patients with residual nonfunctioning pituitary adenomas (NFPAs) who were treated with stereotactic radiosurgery (SRS) and compared the outcomes between early treatment and treatment at progression. The results showed that there was no significant difference in tumor control and preservation of hormonal/visual function between SRS at residual NFPA progression and adjuvant SRS. Deferring radiosurgical management to the time of radiological progression could prolong the onset of radiosurgically induced pituitary dysfunction.
JOURNAL OF NEUROSURGERY
(2023)
Article
Oncology
Yanli Li, Lisha Wu, Tingting Quan, Junyi Fu, Linhui Cao, Xi Li, Shunyao Liang, Minyi Huang, Yinhui Deng, Jinxiu Yu
Summary: This study aimed to report the characteristic of tumor regrowth after gamma knife radiosurgery (GKRS) and outcomes of repeat GKRS in nonfunctioning pituitary adenomas (NFPAs). The study found that parasellar invasion and tumor margin dose (<12 Gy) were independent risk factors for tumor regrowth after GKRS. Repeat GKRS might be effective on tumor control for selected patients.
FRONTIERS IN ONCOLOGY
(2021)
Article
Endocrinology & Metabolism
Roman O. Kowalchuk, Daniel M. Trifiletti, Paul D. Brown, Jason P. Sheehan
Summary: The pituitary gland is a potential site for a range of pathologies, with treatment options including resection and/or ionizing radiation. Stereotactic radiosurgery (SRS) is a highly conformal radiation technique that allows for targeted treatment of pituitary adenomas, resulting in high local tumor control rates and moderate rates of endocrine remission. This article aims to review the indications and supporting literature for using SRS for refractory adenomas.
Article
Endocrinology & Metabolism
Zhishuo Wei, Sila Yavan, Hansen Deng, Arka N. Mallela, Zachary C. Gersey, Rimsha K. Shariff, Pouneh K. Fazeli, Ajay Niranjan, L. Dade Lunsford, Hussam Abou-Al-Shaar
Summary: This study evaluates the role and outcomes of Gamma Knife radiosurgery (GKRS) in the management of pituitary metastases. The results demonstrate that GKRS is an effective treatment modality with good tumor control rate and low risk.
Article
Endocrinology & Metabolism
Stylianos Pikis, Adomas Bunevicius, Jason Sheehan
Summary: This study evaluated the incidence of ICA stenosis and cerebrovascular accident in patients treated with SRS for recurrent or residual pituitary adenoma, finding that there was no significant increased risk for ICA stenosis and ischemic stroke compared to the general population. However, post-SRS radiation vessel injuries should be considered, and prompt identification and management are important to prevent ischemic strokes.
Article
Clinical Neurology
Natasha Ironside, Ching-Jen Chen, Zhiyuan Xu, David Schlesinger, Mary Lee Vance, Gregory K. Hong, Jr John A. Jane, Samir Patel, Shray K. Bindal, Ajay Niranjan, L. Dade Lunsford, Roman Liscak, Thomas Chytka, Jana Jezkova, Omran Saifi, Daniel M. Trifiletti, Assaf Berger, Juan Alzate, Kenneth Bernstein, Douglas Kondziolka, Herwin Speckter, Wenceslao Hernandez, Erwin Lazo, Selcuk Peker, Yavuz Samanci, Brad E. Zacharia, Christine Mau, Rodney E. Wegner, Matthew J. Shepard, David Mathieu, Michel Maillet, Jason P. Sheehan
Summary: This multicenter study investigated the relationship between neuroanatomic structure distances and anterior pituitary function preservation after stereotactic radiosurgery for pituitary adenomas. The study found that a larger distance between the center of the pituitary stalk and the tumor margin isodose was positively associated with anterior pituitary function preservation. This study provides important insights for preserving pituitary function.
Article
Oncology
Felix Ehret, Markus Kufeld, Christoph Fuerweger, Alfred Haidenberger, Paul Windisch, Susanne Fichte, Ralph Lehrke, Carolin Senger, David Kaul, Daniel Ruess, Maximilian Ruge, Christian Schichor, Joerg-Christian Tonn, Guenter Stalla, Alexander Muacevic
Summary: In addition to surgery and medication, robotic radiosurgery is an effective and safe treatment option for growth hormone-secreting tumors of the pituitary gland infiltrating surrounding tissue structures, achieving biochemical disease control or remission in most patients with decreasing hormone levels. The treatment also demonstrates favorable risk and safety profiles.
Review
Oncology
Felix Ehret, Markus Kufeld, Christoph Fuerweger, Alfred Haidenberger, Susanne Fichte, Ralph Lehrke, Carolin Senger, David Kaul, Martin Bleif, Gerd Becker, Daniel Ruess, Maximilian Ruge, Christian Schichor, Joerg-Christian Tonn, Alexander Muacevic
Summary: Meningiomas, especially foramen magnum meningiomas (FMMs) located near vital brain structures, pose a significant neurosurgical challenge. Stereotactic radiosurgery (SRS) has shown to be effective and safe, achieving high local tumor control with favorable outcomes for FMM patients, including those with tumor recurrence or remnants after surgery. SRS should be considered for selected patients, particularly those not suitable for surgery.
Article
Oncology
Lifeng Zhang, Wei Chen, Chang Ding, Yanjia Hu, Yuan Tian, Huiyang Luo, Jing Chen
Summary: The study aimed to investigate the efficacy and safety of initial Gamma Knife radiosurgery for elderly patients with nonfunctioning pituitary adenomas. Results showed that initial GKRS can provide a high tumor control rate as well as low risk of postradiosurgical complications for elderly patients with NFPAs.
JOURNAL OF NEURO-ONCOLOGY
(2021)
Letter
Endocrinology & Metabolism
Frederic Castinetti, Vincent Amodru, Thierry Brue
Summary: This short manuscript reports three cases of atypical adrenal insufficiency with osilodrostat, which is highly effective in blocking cortisol secretion but also carries the risk of adrenal insufficiency.
CLINICAL ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Frederic Castinetti, Philippe Caron, Isabelle Raingeard, Vincent Amodru, Frederique Albarel, Isabelle Morange, Philippe Chanson, Julie Calvo, Thomas Graillon, Karine Baumstarck, Henry Dufour, Jean Regis, Thierry Brue
Summary: This study indicates that while GK exposes patients to a known risk of pituitary deficiency, it does not seem to induce long-term cognitive consequences in patients treated for acromegaly.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2022)
Review
Medicine, General & Internal
Nicolas Sahakian, Frederic Castinetti, Thierry Brue, Thomas Cuny
Summary: This article reviews the current medical therapies used in the field of pituitary tumors, discusses the advantages and limitations of each treatment method, and specifies their positioning in the treatment algorithm for each phenotype. Furthermore, it provides insight into the future of medical therapies for pituitary tumors based on recent studies.
JOURNAL OF CLINICAL MEDICINE
(2022)
Editorial Material
Endocrinology & Metabolism
Frederic Castinetti, Jean-Baptiste De Freminville, Carole Guerin, Erika Cornu, Gabrielle Sarlon, Laurence Amar
Summary: The question of pharmacological treatment before surgery in patients with pheochromocytoma and paraganglioma (PPGL) remains controversial. Some teams believe it is unnecessary in certain cases if the surgery is done in a specialized center. This article discusses the potential benefits and risks of alpha blockers, the first-line treatment for PPGL, and debates the use of preoperative pharmacological treatment.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2022)
Review
Endocrinology & Metabolism
Frederic Castinetti
Summary: Transsphenoidal surgery is the first-line treatment for Cushing's disease, but medical treatment is also an option in certain cases, such as severe hypercortisolism, short-term treatment before surgery, long-term treatment after failed surgery, or while waiting for the full effect of radiation therapy. The approach to medical treatment varies depending on the severity of hypercortisolism, with a block and replace approach for severe cases and a titration approach for mild cases.
JOURNAL OF NEUROENDOCRINOLOGY
(2022)
Review
Oncology
Thomas Cuny, Michael Buchfelder, Henry Dufour, Ashley Grossman, Blandine Gatta-Cherifi, Emmanuel Jouanneau, Gerald Raverot, Alexandre Vasiljevic, Frederic Castinetti
Summary: Craniopharyngiomas (CPs) are challenging tumors located near the pituitary gland and hypothalamus, and they cause severe hormonal deficiencies and increased mortality rate. Current treatment paradigm for CPs involves surgery and radiotherapy, but new targeted therapies are emerging based on the understanding of the molecular mechanisms of tumor growth. Significant research in this field will contribute to better understanding of CPs and prevention of associated complications. This review summarizes the management of CPs in adults and highlights recent studies that advance diagnostic and therapeutic algorithms.
Article
Endocrinology & Metabolism
Nicolas Sahakian, Romain Appay, Noemie Resseguier, Thomas Graillon, Cecilia Piazzola, Cecilia Laure, Dominique Figarella-Branger, Jean Regis, Frederic Castinetti, Thierry Brue, Henry Dufour, Thomas Cuny
Summary: In this study, the prognostic value of the clinicopathological classification of pituitary tumors was examined in 607 patients. The study found that grading of the tumors predicted the risk of progression/recurrence, with invasive and proliferative tumors having a higher risk. Additionally, patients with proliferative tumors were more likely to require retreatment after primary surgery. Radiotherapy was effective in controlling tumor growth in cases of progression or recurrence.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2022)
Review
Endocrinology & Metabolism
Frederic Castinetti, Andre Lacroix
Summary: The desmopressin test has been used for the diagnosis of Cushing syndrome for the past 30 years. Although it has some merits, such as confirming the source of ACTH excess and evaluating the effectiveness of tumor resection, there is a lack of consensus on the criteria for normal or abnormal response to desmopressin. Further research is needed to determine its usefulness.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Endocrinology & Metabolism
Vincent Amodru, Amandine Ferriere, Antoine Tabarin, Frederic Castinetti, Stylianos Tsagarakis, Miklos Toth, Richard A. Feelders, Susan M. Webb, Martin Reincke, Romana Netea-Maier, Darko Kastelan, Atanaska Elenkova, Dominique Maiter, Oskar Ragnarsson, Alicia Santos, Elena Valass
Summary: This study aimed to evaluate age-related differences in clinical characteristics, diagnostic approaches, and management strategies in patients with Cushing's syndrome. Older patients had lower BMI and waist circumference, and a higher prevalence of comorbidities such as muscle weakness, diabetes, hypertension, and cardiovascular disease. They also showed different treatment preferences, with older patients more likely to receive conservative treatment and younger patients preferring surgery.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Kamel Mohammedi, Jerome Bertherat, Gerald Raverot, Delphine Drui, Yves Reznik, Frederic Castinetti, Philippe Chanson, Manon Fafin, Julie Brossaud, Antoine Tabarin
Summary: This study assessed the long-term cortisol exposure in medically treated Cushing disease (CD) patients by measuring the levels of hair cortisol and hair cortisone. Despite normalized urinary free cortisol levels, a subset of patients still displayed altered circadian rhythm of cortisol secretion.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Article
Endocrinology & Metabolism
Thi Thom Mac, Frederic Castinetti, Celine Bar, Sophie Julia, Marlene Pasquet, Pauline Romanet, Alexandru Saveanu, Gregory Mougel, Teddy Fauquier, Nicolas Jullien, Anne Barlier, Rachel Reynaud, Thierry Brue
Summary: Deficient anterior pituitary with common variable immune deficiency (DAVID) syndrome is a rare condition characterized by ACTH deficiency and primary hypogammaglobulinemia caused by NFKB2 gene mutations. A new case of DAVID syndrome was identified and a review of published cases was conducted. Early diagnosis of DAVID syndrome is important to prevent life-threatening complications.
JOURNAL OF NEUROENDOCRINOLOGY
(2023)
Editorial Material
Medicine, General & Internal
Frederic Castinetti, Francoise Borson-Chazot
Summary: Medullary thyroid cancer, although a rare form of thyroid cancer, is significant due to its phenotypic heterogeneity and aggressive behavior, as well as the lack of curative postoperative treatment. About 25% of cases are associated with the genetic tumor syndrome MEN-2, and the first drug targeting the RET gene pathway has been recognized on the 30th anniversary of its discovery.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Review
Endocrinology & Metabolism
Frederique Albarel, Thomas Cuny, Thomas Graillon, Henry Dufour, Thierry Brue, Frederic Castinetti
Summary: Transsphenoidal surgery is the primary treatment for acromegaly, but surgical remission rates can be affected by various factors. The benefits of presurgical medical treatment using somatostatin receptor ligands (SRLs) are still unclear, but it may improve patient condition and decrease surgical complications by normalizing hormone levels and reducing tumor size.
JOURNAL OF THE ENDOCRINE SOCIETY
(2022)
Letter
Endocrinology & Metabolism
Adele Lasbleiz, Nunzia Cinzia Paladino, Pauline Romanet, Frederic Castinetti, Thomas Cuny, Frederic Sebag, David Taieb