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Low-dose pituitary irradiation for acromegaly
M D Littley1, S M Shalet, R Swindell
1Department of Endocrinology, Christie Hospital, Withington, Manchester, UK.
Clinical Endocrinology
|February 1, 1990
Summary
External radiotherapy can treat acromegaly, particularly when growth hormone levels remain high post-surgery. Lower radiation doses may offer benefits, especially for younger patients, but maximizing surgical removal of tumor tissue is crucial for successful outcomes.
Area of Science:
- Endocrinology
- Radiation Oncology
Background:
- Acromegaly is a disorder caused by excess growth hormone (GH).
- External radiotherapy is a treatment option for acromegaly, used alone or after surgery.
Purpose of the Study:
- To evaluate the effectiveness of external radiotherapy in treating acromegaly.
- To determine factors influencing successful radiotherapy outcomes in acromegaly patients.
Main Methods:
- Retrospective analysis of 73 acromegaly patients treated with radiotherapy.
- Comparison of two radiotherapy schedules: 20 Gy in 8 fractions or 35-40 Gy in 15 fractions.
- Analysis of pre- and post-radiotherapy GH levels, considering factors like prior surgery and initial GH levels.
Main Results:
- Non-irradiated patients showed unchanged or increased GH hypersecretion.
- Radiotherapy dose did not significantly affect the likelihood of achieving a mean GH level < 5 mU/l during GTT.
- Patients with pre-radiotherapy GH < 30 mU/l had a significantly higher probability of achieving post-radiotherapy GH < 5 mU/l (P = 0.002).
Conclusions:
- Lower radiotherapy doses (20 Gy) may be beneficial in acromegaly, particularly for younger patients, considering the risk of hypopituitarism.
- Maximizing surgical removal of GH-secreting tissue pre-radiotherapy improves the chances of cure.
- Previous surgery, initial prolactin, age, and sex did not predict radiotherapy success.