title: Persistent or recurrent acromegaly. Long-term endocrinologic efficacy and neurologic safety of postsurgical radiation therapy.
abstract: As in other clinics, pituitary surgery was definitive treatment in less than 50% of cases of acromegaly treated at one institution over several decades. From 1965 to 1989, 24 acromegalic patients who had noncurative pituitary surgery received radiation therapy at the National Institutes of Health, with a basal human growth hormone level of greater than 5 ng/ml as the criterion for active disease. Using megavoltage irradiation, more than 60% of these patients stabilized at a normal hormonal range, and the overwhelming majority had decreasing growth hormone levels with time. No major side effects of irradiation were encountered except panhypopituitarism of varying degrees. The authors evolved a policy of surgery as the first option, followed by irradiation for patients with postoperative growth hormone levels more than 5 ng/ml.
authors.affiliation: Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
authors.forename: T E
authors.initials: TE
authors.lastname: Goffman
authors.forename: R
authors.initials: R
authors.lastname: Dewan
authors.forename: R
authors.initials: R
authors.lastname: Arakaki
authors.forename: P
authors.initials: P
authors.lastname: Gorden
authors.forename: E H
authors.initials: EH
authors.lastname: Oldfield
authors.forename: E
authors.initials: E
authors.lastname: Glatstein
mesh_terms: D000172:Acromegaly / Q000378:metabolism / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D003131:Combined Modality Therapy; D004702:Endocrine Glands / Q000528:radiation effects*; D005260:Female; D013006:Growth Hormone / Q000378:metabolism / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009420:Nervous System / Q000528:radiation effects; D011882:Radiotherapy, High-Energy / Q000379:methods; D012008:Recurrence
chemical_list: D013006:Growth Hormone