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
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
收藏
页码:55 / 62
页数:7
相关论文
共 64 条
[31]  
Colao A., Marzullo P., Vallone G., Et al., Reversibility of joint thickening in acromegalic patients
[32]  
an ultrasonography study, J Clin Endocrinol Metab, 83, pp. 212-215, (1998)
[33]  
Jaffe C.A., Barkan A.L., Acromegaly: Recognition and drug treatment, Drugs, 47, pp. 425-445, (1994)
[34]  
Ciccarelli E., Valett M.R., Vasario E., Avateneo T., Grottoli S., Camanni F., Hormonal and radiologic effects of megavoltage radiotherapy in patients with growth hormone-secreting pituitary adenoma, J Endocrinol Invest, 16, pp. 565-572, (1993)
[35]  
Af Traupe E., Lundell G., Lax I., Werner S., External irradiation of growth hormone producing pituitary adenomas: Prolactin as a marker of hypothalamic and pituitary effects, Int J Radiat Oncol Biol Phys, 20, pp. 655-660, (1991)
[36]  
Thalassinos N.C., Tsagarakis S., Ioannides G., Tzavara I., Papavasiliou C., Megavoltage pituitary irradiation lowers but seldom leads to safe GH levels in acromegaly: A long term follow-up study, Eur J Endocrinol, 138, pp. 160-163, (1998)
[37]  
Lucas T., Brito M., Estrada J., Alcaniz A., Magallon R., G-Uria J., Barcelo B., Conventional radiotherapy in the treatment of acromegaly: Is it a choice?, Program of the Fifth International Pituitary Congress, (1998)
[38]  
Ludecke D.K., Lutz B.S., Niedworok G., The choice of treatment after incomplete adenomectomy in acromegaly: Proton versus highvoltage radiation, Act Neurochir, 96, pp. 32-38, (1989)
[39]  
Thoren M., Rahn T., Guo W.Y., Werner S., Stereotactic radiosurgery with the cobalt-60 gamma unit in the treatment of growth hormone-producing pituitary tumors, Neurosurgery, 29, pp. 663-668, (1991)
[40]  
Vance M.L., Woodburn J., Steiner L., Laws E.R., Gamma knife radiation for functinal pituitary adenomas, 80th Annual Meeting of the Endocrine Society, (1998)