Long-term outcomes of pituitary radiotherapy and their predictive factors in childhood and adolescent-onset Cushing disease
Authors' conclusion
Our study illustrates the favorable remission rates post-CRT in childhood and adolescent CD, with lower rates of new-onset HH/CHT. Ongoing monitoring is required, as relapse can occur in one-fourth of cases.
Study context
- Population
- Cushing disease (CD) patients <20 years at presentation treated with conformal-RT (CRT) 1994–2024, minimum 1-year follow-up post-CRT; 21 males, 7 prepubertal, 24 microadenomasof 108 CD patients
- Participants
- 34 patients
- Exposure
- First-line CRT vs Second-line CRT vs Third-line CRT
- Outcome
- Remission post-CRT
- Follow-up
- 16.5 (8.75-39.25) months
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Remission, overall cohort
- 25/34 (73.5%)
- Younger age at CD diagnosis independently predicted remission (HR)
- 0.805, P = .02
Observational data: associations, not effects.
Further findings
Relapse post-CRT · 19.0 (18.3-30.3) months
- Relapse
- 6/25 (24%)
- Ketoconazole use predicted relapse
- P = 0.006
Safety
Pituitary hormone deficiencies post-CRT
- GHD
- 17/20 (85%)
- Low IGF-1 levels
- 29/34 (41.4%)
- New-onset hypogonadotropic hypogonadism (HH)
- 3/24 (12.5%)
- New-onset central hypothyroidism
- 4/24 (16.7%)
- Older age at CD diagnosis predicted new-onset HH and/or central hypothyroidism (CHT)
- 17.5 vs. 13.0 years; P = .02
- Older age at CRT predicted new-onset HH and/or CHT
- 23 vs. 14 years; P = .04
Original publication
Long-term outcomes of pituitary radiotherapy and their predictive factors in childhood and adolescent-onset Cushing disease. Eur J Endocrinol. Published 24 July 2025. doi:10.
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