Document Detail


Outcome of stereotactic radiotherapy for patients with uncontrolled acromegaly.
MedLine Citation:
PMID:  19650358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Linear accelerator based stereotactic radiation therapy (SRT) has been used for the treatment of pituitary tumours; however, little is known concerning the use of this modality for the treatment of patients with acromegaly. We have prospectively studied the short-term outcome of SRT in 12 acromegaly patients who failed to achieve biochemical remission despite surgery and/or pharmacologic therapy. METHODS: We identified all patients who had biochemically uncontrolled acromegaly and were treated with SRT between April 2003 and December 2006. All patients were followed prospectively based on a pre-defined protocol that included Goldman visual field examination, MRI of the sella, and pituitary hormone testing at 3, 6, 12 months, and then yearly. RESULTS: A total of 12 patients with acromegaly were treated with SRT. There were 9 females and the median age of the group was 50 years. The median follow-up was 28.5 months during which time the mean tumor volume decreased by 40%, the median GH fell from 4.1 microg/L to 1.3 microg/L (p = 0.003) and the median IGF-1 dropped more than half from 545.5 microg/L to 260.5 microg/L (p = 0.002). Four patients achieved normal, while an additional 2 achieved near-normal, IGF-1 levels. One patient was able to discontinue and two were able to reduce their acromegaly medications while maintaining a normal IGF-1. A new pituitary hormonal deficit was found at 24 months in one patient who developed hypoadrenalism requiring corticosteroid replacement. CONCLUSION: Based on our early experience, we believe that SRT should be considered in treating patients with uncontrolled acromegaly.
Authors:
Syed Ali Imran; Ian G Fleetwood; Colleen M O'Connell; Thomas P Ransom; Liam A Mulroy; Ehud Ur; David B Clarke
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques     Volume:  36     ISSN:  0317-1671     ISO Abbreviation:  Can J Neurol Sci     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-08-04     Completed Date:  2009-09-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0415227     Medline TA:  Can J Neurol Sci     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  468-74     Citation Subset:  IM    
Affiliation:
Halifax Neuropituitary Program, Department of Medicine Endocrinology, Dalhousie University, Halifax, Nova Scotia, Canada.
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / metabolism,  pathology,  physiopathology,  surgery*
Adult
Female
Follow-Up Studies
Growth Hormone / metabolism
Humans
Insulin-Like Growth Factor I / metabolism
Magnetic Resonance Imaging / methods
Male
Middle Aged
Radiosurgery*
Statistics, Nonparametric
Treatment Outcome
Visual Fields / physiology
Chemical
Reg. No./Substance:
67763-96-6/Insulin-Like Growth Factor I; 9002-72-6/Growth Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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