Pituitary irradiation in acromegaly

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Eighteen patients with acromegaly were evaluated at the Nassau County Medical Center (NCMC) in the past four years. Six patients had received pituitary irradiation at other institutions, and two patients remained untreated, Six of the 12 patients in whom at least one year had elapsed since pituitary irradiation had fasting growth hormone (STH) levels in the normal range. In the patients treated with 5500 rads at the NCMC, there was a 70 percent mean decrease in STH levels by 6–25 months. Panhypopituitarism was present in two patients who were treated elsewhere, and one patient treated at NCMC developed hypogonadotropic hypogonadism. No patient developed visula field defects. Although pituitary irradiation does not lower STH levels as rapidly as surgery, there is no associated mortality, and virtually no morbidity. Pituitary irradiation is recommended as the primary form of therapy for acromegaly when there is no evidence of extrasellar extension.

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