Endocrine Abstracts

Aim: To evaluate the effectiveness of radiation therapy (RT) in patients with acromegaly, depending on the age of patients and the activity of pituitary adenomas.

Materials and methods: The subject of the study were 50 patients (women-36, men-14) with acromegaly who received gammatherapy in a total dose of 45–60 Gr of 20–25 fractions every other day. The duration of the disease was 15 years on average. In general, the age of patients ranged from 26 to 77years, on average-44.7 ± 6.8 years. By age, the patients were divided into 3 groups: the I age group-29–44 years-23 patients (46%), the II group-45–59 year-16 patients (32%), the III group-60–79 years, 11 patients (22%). All patients underwent hormonal (GH, IGF-1) studies.

Results: The levels of hormones of GH and IGF-1 remained high in the I group in 22% of patients, and in group III in 9%. Remissions reached 64% in the III age group. The highest level of GH content occurred in the age range from 45 to 59 years and was 77.5 ± 9.68 mMе/l, and from 26 to 44years it was 68.1 ± 6.84 mMе/l. After RT, this indicator in both age groups was almost equally suppressed, but not up to the norm. The decrease in the GH level to normal was observed in I age group in eight patients, and in the II age group in five patients it was 2.65 ± 2.2 mMе/l and 2.23 ± 1.4 mMе/l, respectively. In group III, in 11 patients before RT, the mean level of GH was 46.5 ± 8.2 mMе/l. After RT, the level of GH decreased in this way: not suppressed only in one patient and was 22.1 ± 0.89 mMе/l, in three patients the level of GH was suppressed, but not up to the norm and amounted to 6.7 ± 0.7 mMe/l, only seven patients were suppressed and amounted to 2.46 ± 2.2 mMe/l.

Conclusion: In all age periods, even in the period of the most activity pituitary adenoma-at the age of 26–44 years, RT is a rather effective method of treatment and gives positive results in most cases.