Gamma Knife radiosurgery safe for hypothalamic hamartoma
Gamma Knife (GK) radiosurgery is a safe approach to hypothalamic hamartoma, a new study reveals. Specifically, there are no major endocrine side effects observed.
GK, with a mean dose of 17.1±2.3 Gy, was delivered to 34 patients with mean age at surgery of 18.2±11.1 years. The mean BMI of the cohort was 25.1±2.8 kg/m2. GK was a first-line treatment in 32 patients while the remaining two had undergone prior surgeries. The mean time to follow-up after surgery was 3.6±2 years.
One patient experienced a weight gain of around 10 kg following GK surgery; by final evaluation, weight had returned to a level comparable to baseline. Mean BMI after GK surgery was 26.9 kg/m2, and no significant difference in pre- and post-GK BMI was calculated (p=0.59).
There was one case of new pituitary deficiency: thyroid stimulating hormone deficiency diagnosed 2 years after GK surgery and which persisted until 5 years after the procedure.
Two patients had deficiencies in luteinizing hormone (LH)/follicle-stimulating hormone (FSH) levels at baseline and showed no unusual significant changes over the course of the study. No other gonadotroph deficiencies were detected.
Similar to baseline, there were no documented deficiencies in adenocorticotropin hormone (ACTH) and growth hormone (GH). No abnormal changes in prolactin, sodium and diuresis were observed.
Participants with hypothalamic hamartoma and who had endocrinologic follow-up of at least 2 years after treatment were included. Evaluations were at 3 months and 2 years after GK. Among the information retrieved from records were radiosurgical parameters, hamartoma characteristics, anthropometric measurements and endocrinologic evaluation results.