Academic Journal
Intracavitary Yttrium-90 Colloid Therapy for Cystic Sellar Masses: A Phase II Clinical Trial With 5-Year Follow-Up.
| Τίτλος: | Intracavitary Yttrium-90 Colloid Therapy for Cystic Sellar Masses: A Phase II Clinical Trial With 5-Year Follow-Up. |
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| Συγγραφείς: | MacLean MA; Department of Surgery (Neurosurgery), Dalhousie University, Halifax , Canada., Ahmad S; Department of Medicine (Endocrinology), Dalhousie University, Halifax , Canada., Hebb ALO; Department of Surgery (Neurosurgery), Dalhousie University, Halifax , Canada., Tahir A; Department of Surgery (Neurosurgery), Dalhousie University, Halifax , Canada., Greene R; Department of Surgery (Neurosurgery), Dalhousie University, Halifax , Canada., Burrell S; Department of Diagnostic Radiology, Faculty of Medicine, Dalhousie University, Halifax , Canada., Imran SA; Department of Surgery (Neurosurgery), Dalhousie University, Halifax , Canada.; Department of Medicine (Endocrinology), Dalhousie University, Halifax , Canada., Clarke DB; Department of Surgery (Neurosurgery), Dalhousie University, Halifax , Canada.; Department of Medicine (Endocrinology), Dalhousie University, Halifax , Canada. |
| Πηγή: | Neurosurgery [Neurosurgery] 2025 Nov 01; Vol. 97 (5), pp. 1100-1107. Date of Electronic Publication: 2025 Apr 23. |
| Τύπος έκδοσης: | Journal Article; Clinical Trial, Phase II |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Lippincott Williams & Wilkins, Inc Country of Publication: United States NLM ID: 7802914 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1524-4040 (Electronic) Linking ISSN: 0148396X NLM ISO Abbreviation: Neurosurgery Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2022- : [Philadelphia] : Lippincott Williams & Wilkins, Inc. Original Publication: Baltimore, Williams & Wilkins. |
| Ιατρικοί όροι (MeSH): | Pituitary Neoplasms*/radiotherapy , Central Nervous System Cysts*/radiotherapy, Radiosurgery/methods ; Colloids/therapeutic use ; Humans ; Female ; Middle Aged ; Male ; Aged ; Follow-Up Studies ; Adult ; Treatment Outcome ; Prospective Studies |
| Περίληψη: | Background and Objectives: Stereotactic intracavitary irradiation of cystic sellar masses (CSMs) with 90-Yttrium colloid ( 90 Y) may mitigate significant morbidity and/or recurrence rates associated with traditional microsurgical resection. In this study, we aimed to prospectively assess the long-term effect of 90 Y on tumor-cyst volume, endocrine, and vision outcomes after treatment of CSMs. Methods: We conducted a Health Canada-approved, phase II, open label, prospective clinical trial. The primary indication for treatment was clinical evidence of mass effect on initial presentation or subsequent cyst enlargement. Patients underwent right frontal stereotactic insertion of 90 Y (200 Gy to the cyst wall). Cyst volumes were measured using serial MRI. Visual field (VF) assessment and hypothalamic-pituitary hormone panel were obtained. Outcomes were collected postoperatively at 3, 9, and 24 months, then annually up to 5 years. Results: Twenty-two patients (55% women, mean age = 63.6 years [SD 15.4]) received 90 Y. The mean follow-up was 52 months (5-113). Primary diagnoses were the following: craniopharyngioma (86%), Rathke cleft cyst (9%), and cystic prolactinoma (5%). Preoperative clinical features included VF deficit (41%), VF deficit plus headache (36%), or headache alone (13%). For the aggregate cohort, statistically significant reduction in mean tumor-cyst volume for the cohort was observed at all follow-up visits beyond 3 months (all P < .01). At 5-year follow-up, cyst volume reduction was sustained in 82% of cases. The mean percent reduction in tumor-cyst volume was 77.2% (SD 16.8). Ninety-one percent of patients had stable or improved vision postoperatively. The overall proportion of patients with endocrine dysfunction preoperatively (59%) and postoperatively (68%) remained stable ( P > .05). Treatment failure requiring conventional surgery occurred in 3 patients who received 90 Y for cyst recurrence. Conclusion: Stereotactic treatment of CSMs with intracavitary 90 Y is associated with sustained reduction in tumor-cyst volume, improved visual function, and stable endocrine function at 5-year follow-up. (Copyright © Congress of Neurological Surgeons 2025. All rights reserved.) |
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| Contributed Indexing: | Keywords: Clinical trial; Oncology; Stereotactic; Tumor; Yttrium |
| Substance Nomenclature: | 0 (Colloids) |
| Entry Date(s): | Date Created: 20250423 Date Completed: 20251015 Latest Revision: 20251130 |
| Update Code: | 20260130 |
| DOI: | 10.1227/neu.0000000000003460 |
| PMID: | 40265892 |
| Βάση Δεδομένων: | MEDLINE |
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