Abstract
The treatment goals for patients with growth hormone (GH)-secreting pituitary adenomas are tumor control, biochemical remission, preservation of anterior pituitary function, and minimal treatment-related complications. Surgical resection is the preferred treatment for most patients with acromegaly because tumor removal provides rapid biochemical remission thereby eliminating the need for lifelong medical therapy. However, patients with pituitary macroadenomas and patients with tumors that extend into the cavernous sinuses generally cannot be cured with surgery alone and some form of adjuvant radiation is indicated. Both external beam radiation therapy (EBRT) and stereotactic radiosurgery (SRS) provide high rates of tumor control and significantly reduce serum GH and insulin-like growth factor-I. The primary risk of both EBRT and SRS for acromegalic patients is new pituitary hormone deficiencies. The time to biochemical remission is shorter after SRS compared to EBRT, and the risk of radiation-induced tumors is significantly lower with SRS. These factors combined with the practical benefits of SRS (1–5 days vs. 5–6 weeks of treatment time) have made SRS the preferred radiation technique for properly selected acromegalic patients who fail or cannot tolerate surgical resection or medical therapy.
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Pollock, B.E. (2011). The Role of External Beam Radiation Therapy and Stereotactic Radiosurgery in Acromegaly. In: Ho, K. (eds) Growth Hormone Related Diseases and Therapy. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-60761-317-6_15
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DOI: https://doi.org/10.1007/978-1-60761-317-6_15
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