Intensity-modulated radiotherapy for cushing’s disease: single-center experience in 70 patients

Context Intensity-modulated radiotherapy (IMRT) is a modern precision technique for the treatment of pituitary adenoma. Objective Aim to investigate efficacy and toxicity IMRT in treating Cushing’s Disease (CD). Methods 70 115 patients with CD treated at our institute from April 2012 August 2021 were included study. The radiation doses usually 45-50 Gy 25 fractions. After IMRT, endocrine evaluations performed every 6 months magnetic resonance imaging (MRI) annually. Endocrine remission was defined as suppression 1 mg dexamethasone test (DST) or normal 24-hour urinary free cortisol level (24hUFC). outcome remission, recurrence, tumor control complications retrieved medical record. Results At median follow-up time 36.8 months, rate 1, 2, 3 5 years 28.5%, 50.2%, 62.5% 74.0%, respectively. 24 (95%CI: 14.0-34.0). recurrence found (13.5%) till last follow-up. recurrence-free after 98.2%, 93.9%, 88.7% 88.7%, 98%. overall incidence new onset hypopituitarism 22.9%, hypothyroidism serving most common individual axis deficiency. Univariate analysis indicated that only higher Ki-67 index (P=0.044) significant favorable factors remission. Conclusion highly effective second-line therapy low side effect profile patients. rates comparable previous reports on FRT SRS.