ECE2011 Poster Presentations Pituitary (111 abstracts)
Long-term effects of radiotherapy on cardiovascular risk factors in acromegaly
C L Ronchi 1, , E Verrua 1, , E Ferrante 1, , G Bender 3 , E Sala 1, , A Lania 2 , M Fassnacht 3 , P Beck-Peccoz 1, , Bruno Allolio 3 , Anna Spada 1, & Maura Arosio 2,
1Unit of Endocrinology and Diabetology, Fondazione IRCCS Ospedale Maggiore Policlinico, Milan, Italy; 2Department of Medical Science, University of Milan, Milan, Italy; 3Unit of Endocrinology, University Hospital of Wuerzburg, Wuerzburg, Germany; 4Unit of Endocrine Diseases, S. Giuseppe Multimedica Hospital, Milan, Italy.
Radiation therapy is a useful adjuvant tool for the management of difficult acromegalic patients. Its effects on cardiovascular morbidity are still unknown. Aim of the study was to investigate the long-term effects of radiotherapy on metabolic parameters and cardiovascular risk factors.
A total of 42 acromegalic patients (11 M and 31 F, age: 55±12 years, RT group), cured after conventional RT (CRT, n=31) or radiosurgery by gamma-knife (GKRS, n=11), have been retrospectively evaluated (median follow-up: 16.5 years, range: 2–40). Fifty-six sex- and age-matched acromegalic patients cured after surgery alone served as control group. GH/IGFI secretion, anterior-pituitary functions, metabolic parameters and cardiovascular risk factors (BMI, fasting glucose and insulin, 2 h-OGTT glucose, HOMA-IR, HOMA-B%, HbA1c, lipid profile, blood pressure) and the occurrence of new cardiac or cerebrovascular events have been investigated.
The median time from disease remission was similar in the RT and control group (10.6 vs 13.4 years, P NS). GH and IGFI levels were also comparable. As expected, the percentage of patients with pituitary failure was higher in RT patients than in controls (86 vs 30%, P<0.0005). The number of obese, hypertensive, and dyslipidemic subjects increased over time only in the RT group, whereas the glucose response to the OGTT and the percentage of subjects with glucose alterations improve only in control group. Despite these findings, a similar number of patients in the two groups had major cardiac or cerebrovascular events (4/42, two IMA and two TIA, vs 3/56, one stroke and two TIA). No differences were found between CRT and GKRS subgroups. In conclusion, previous RT seems to be associated with a worse metabolic profile in acromegalic patients studied after a long-term follow-up. Nevertheless, a direct link between RT and cardiovascular events remains to be proven.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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