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Long-term effects of radiotherapy on cardiovascular risk factors in acromegaly.
MedLine Citation:
PMID:  21300733     Owner:  NLM     Status:  Publisher    
Objective: Radiation therapy (RT) is a useful adjuvant tool for acromegalic patients not cured by surgery and/or not responding to pharmacotherapy. However, its specific effects on cardio- and cerebrovascular morbidity are still on debate. Design: Retrospective analysis of 42 acromegalic patients cured after conventional radiotherapy (CRT, n=31) or radiosurgery by gamma-knife (GKRS, n=11) followed for a median period of 16.5 years (range: 2-40). Fifty-six patients cured by surgery alone, with similar GH/IGF-I levels and duration of disease remission, served as control group. Methods: changes in cardiovascular risk factors, such as BMI, glucose metabolism, insulin resistance, blood pressure, and lipid profile (pre-defined primary end point) and occurrence of new major cardiac and cerebrovascular events (secondary end point) during follow-up. Results: The number of obese, hypertensive, and dyslipidemic subjects increased over time only in patients cured with RT. In contrast, the glucose response to the oral glucose tolerance test and the percentage of subjects with glucose alterations improved only in controls. As expected, the percentage of patients with pituitary failure was deeply higher among RT patients than among controls (86% vs 30%, P<0.0005). Despite these findings, a similar number of RT patients and controls developed major cardiac or cerebrovascular events (4/42 vs 3/56, P NS). No differences were found between CRT and GKRS subgroups. Conclusions: previous RT seems to be associated with a worse metabolic profile in acromegalic patients studied after a long-term follow-up. Nevertheless, a direct link between RT and cardiovascular events remains to be proven.
Cristina Lucia Ronchi; Elisa Verrua; Emanuele Ferrante; Gwendolyn Bender; Elisa Sala; Andrea Lania; Martin Fassnacht; Paolo Beck-Peccoz; Bruno Allolio; Anna Spada; Maura Arosio
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-7
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
C Ronchi, Unit of Endocrinology and Diabetology, Fondazione IRCCS Ospedale Maggiore Policlinico, Milan, 20135 , Italy.
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