Abstract：
Stereotactic radiosurgery (SRS) more and more frequently plays a crucial role in the treatment of acromegaly. We provide a systematic review of the literature and meta-analysis, according to PRISMA, on SRS for the management of growth hormone (GH)-secreting pituitary adenomas, including several radiosurgical techniques, with the aim of describing efficacy and safety of this treatment. A weighted random effects model was used to calculate pooled outcome estimates. From 346 abstract reviews, 27 retrospective studies were included. Despite the variability in hormonal remission criteria and the heterogeneity between treatment guidelines among included studies, most of them reported an endocrine remission rate between 40% and 60%. Random effects meta-analysis for overall endocrine remission and 5-year probability of remission estimate after SRS were 46% (95% CI: 39-53%) and of 48% (95% CI: 38-57%), respectively. Random effects meta-analysis for new hypopituitarism estimate after SRS was 23% (95% CI: 17-29%). Furthermore, incidence of radiation induced optic neuropathy after SRS ranged between 0% and 6% This meta-analysis confirms and quantifies safety and effectiveness of SRS to achieve endocrine remission after surgical management in acromegaly.
摘要：
立体定向放射外科（SRS）在肢端肥大症的治疗中起着至关重要的作用。我们对文献和荟萃分析进行了系统的回顾，根据PRISMA的说法,关于SRS治疗分泌生长激素（GH）的垂体腺瘤，包括几种放射外科技术，目的是描述这种治疗的疗效和安全性。使用加权随机效应模型来计算合并结果估计值。来自346条抽象评论，纳入27项回顾性研究。尽管激素缓解标准的可变性和纳入研究的治疗指南之间的异质性，他们中的大多数报告内分泌缓解率在40%至60%之间。SRS后总体内分泌缓解和5年缓解概率估计的随机效应荟萃分析为46％（95％CI：39-53％）和48％（95％CI：38-57％），分别。SRS后新的垂体功能减退估计的随机效应荟萃分析为23％（95％CI：17-29％）。此外，SRS后辐射诱发的视神经病变的发生率介于0%至6%之间。这项荟萃分析证实并量化了在肢端肥大症手术治疗后SRS实现内分泌缓解的安全性和有效性。
