| Conventional pituitary irradiation is effective in normalising plasma IGF-I in patients with acromegaly. | |
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MedLine Citation:
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PMID: 11182746 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: For patients in whom acromegaly persists despite pituitary surgery, conventional pituitary irradiation represents an additional treatment option. A 30-60% cure rate is described in the literature, but these studies did not utilise strict rules of remission, such as "safe" GH levels <2.5 microg/l, and age-adjusted normal IGF-I levels. DESIGN AND METHODS: We report the outcome of 41 patients with acromegaly who received pituitary conventional external irradiation. The median follow-up time was 12.8 years (3.7-43.4 years) post-radiotherapy. RESULTS: The median pre-irradiation GH level was 31.0 microg/l (7.0-210 microg/l). Information on IGF-I levels was only available for 6 patients prior to therapy. Utilising strict rules of remission, one-third (14/41) of our patients had normal biochemical parameters, i.e. "safe" GH (0.5 microg/l (range 0.2-1.6 microg/l)) and normal age-adjusted IGF-I levels (multiple of upper limit of normal range (xULN); 0.45 (0.2-1.0)) at the end of the follow-up period. An additional 9 patients achieved normal levels with adjunctive drug therapy. Furthermore, disease activity was reduced in a considerable proportion of the 18 patients who did not achieve normal biochemical levels (GH: 3.6 microg/l (1.9-15.7 microg/l); xULN of IGF-I: 1.6 (0.9-2.6)). In retrospect, remission is unlikely in patients who had a GH level greater than 52 microg/l (mean+2 s.d. of cured patients) prior to radiotherapy. In addition to the 12 patients with pre-irradiation pituitary functional deficiency, another 11 patients developed symptoms of panhypopituitarism during the 3-year period following irradiation. Within a 6-year period, partial pituitary insufficiency was observed in a further 7 patients, thus necessitating hormone substitution treatment. CONCLUSION: Using strict rules of remission, in our cohort we found both a normalisation of IGF-I and safe GH levels in 34% of patients treated for acromegaly with conventional irradiation therapy. |
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Authors:
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B Gutt; C Hatzack; K Morrison; B Pöllinger; J Schopohl |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of endocrinology / European Federation of Endocrine Societies Volume: 144 ISSN: 0804-4643 ISO Abbreviation: Eur. J. Endocrinol. Publication Date: 2001 Feb |
Date Detail:
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Created Date: 2001-02-22 Completed Date: 2001-03-29 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9423848 Medline TA: Eur J Endocrinol Country: England |
Other Details:
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Languages: eng Pagination: 109-16 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Medizinische Klinik Innenstadt, University of Munich, Ziemssenstrasse 1, D-80336 Munich, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acromegaly
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blood*,
physiopathology,
radiotherapy* Adult Aged Cohort Studies Female Human Growth Hormone / blood Humans Insulin-Like Growth Factor I / analysis* Male Middle Aged Osmolar Concentration Pituitary Gland / radiation effects* Pituitary Gland, Anterior / physiopathology Reference Values Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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12629-01-5/Human Growth Hormone; 67763-96-6/Insulin-Like Growth Factor I |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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