Reevaluation of Conventional Pituitary Irradiation in the Therapy of Acromegaly

被引：12

作者：

Jaffe C.A. ^{[1
,2
]}

机构：

[1] Department of Internal Medicine, Univ. of Michigan Medical Center, Ann Arbor Vet. Aff. Medical Center

[2] 3920 Taubman Center, Ann Arbor, MI 48109-0354

来源：

Pituitary | 1999年 / 2卷 / 1期

关键词：

Adenoma; Anterior pituitary; Growth hormone; Insulin-like growth factor I; Neoplasia;

D O I：

10.1023/A:1009969921497

中图分类号：

学科分类号：

摘要：

External beam pituitary irradiation has been frequently used in the treatment of growth hormone (GH) secreting pituitary adenomas. Many studies have demonstrated that serum GH declines rapidly and reliably following treatment and early "cure" rates, based on a basal serum GH below 10 μg/L were as high as 80%. The definition of "cure" has become more stringent over time and retrospective studies have indicated that GH must be below 2.5 μg/L for acromegalics to achieve mortality rates comparable to a normal population. Only 20% of irradiated patients will achieve this goal by 10 yr. Even fewer will achieve a normal serum insulin-like growth factor I (IGF-I) levels. Although pituitary irradiation still has a role in the control of tumor size, its importance as a treatment for normalizing serum GH is being reevaluated.

引用

页码：55 / 62

页数：7

共 64 条

[1]

Clayton R.N., New developments in the management of acromegaly. Should we achieve absolute biochemical cure, J Endocrinol, 155, (1997)

[2]

Laws E.R., Piepgras D.G., Randall R.V., Abboud C.F., Neurosurgical management of acromegaly. Results in 82 patients treated between 1972 and 1977, J Neurosurg, 50, pp. 454-461, (1979)

[3]

Jaffe C.A., Barkan A.L., Treatment of acromegaly with dopamine agonists, Endocrinol Metab Clin North Am, 21, pp. 713-735, (1992)

[4]

Fahlbusch R., Honegger J., Buchfelder M., Evidence supporting surgery as treatment of choice for acromegaly, J Endocrinol, 155, (1997)

[5]

Jenkins D., O'Brien I., Johnson A., Shakespear R., Sheppard M.C., Stewart P.M., The Birmingham pituitary database: Auditing the outcome of the treatment of acromegaly, Clin Endocrinol, pp. 517-522, (1995)

[6]

Bates A.S., Van't Hoff W., Jones J.M., Clayton R.N., An audit of outcome of treatment in acromegaly, Q J Med, 86, pp. 293-299, (1993)

[7]

Rajasoorya C., Holdaway I.M., Wrightson P., Scott D.J., Ibbertson H.K., Determinants of clinical outcome and survival in acromegaly, Clin Endocrinol, 41, pp. 95-102, (1994)

[8]

Wrightson P., Rajasoorya C., Holdaway M., Scott J., Acromegaly: Factors affecting the long-term outcome after surgical treatment, J Clin Neurosci, 1, pp. 164-172, (1994)

[9]

Jaffe C.A., Turgeon D.K., DeMott Friberg R., Watkins P.B., Barkan A.L., Nocturnal augmentation of growth hormone (GH) secretion is preserved during repetitive bolus administration of GH-releasing hormone: Potential involvement of endogenous somatostatin, J Clin Endocrinol Metabol, 80, pp. 3321-3326, (1995)

[10]

Jaffe C.A., Ocampo-Lim B.N., Krueger K., Sugahara I., Mauger D.T., DeMott-Friberg R., Barkan A.L., Sexual dimorphism of growth hormone secretion and regulation in humans, J Clin Invest, 102, pp. 153-164, (1998)

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