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[External pituitary irradiation therapy for acromegaly]
1Department of Endocrinology, Peking Union Medical College Hospital, Beijing.
Zhonghua Nei Ke Za Zhi
|July 1, 1992
Summary
External pituitary irradiation effectively lowers human growth hormone (hGH) levels in acromegaly patients. Doses below 4000 rad were less effective, highlighting the importance of adequate radiation dosage for treatment success.
Area of Science:
- Endocrinology
- Oncology
- Radiation Oncology
Context:
- Acromegaly is a chronic endocrine disorder caused by excess human growth hormone (hGH).
- External pituitary irradiation is a treatment modality for acromegaly.
- Long-term efficacy of pituitary irradiation requires evaluation.
Purpose:
- To assess the long-term efficacy of external pituitary irradiation in managing acromegaly.
- To evaluate the impact of radiation dosage on hGH reduction.
- To identify factors influencing treatment outcomes.
Summary:
- 128 acromegaly patients underwent follow-up after pituitary irradiation (mean 5.9 years).
- Fractional irradiation (4000-5000 rad) led to progressive hGH decrease (35.1%/year initially).
- 36.2% achieved inactivity (hGH ≤ 5 ng/ml), 62.1% were slightly active (hGH ≤ 10 ng/ml) by year 15.
- Treatment effectiveness correlated with radiation dose; <4000 rad was less effective.
- Age, acromegaly course, sella size, and prior surgery did not influence outcomes.
Impact:
- External pituitary irradiation is an effective treatment for acromegaly, leading to sustained hGH reduction.
- Optimal radiation dosage (≥4000 rad) is crucial for achieving clinical inactivity.
- This study provides evidence for the long-term benefits and dose-dependency of pituitary irradiation in acromegaly management.