Radiation therapy has been used both as a primary acromegaly treatment and combined with surgery or drugs. It is usually reserved for patients who have tumors remaining after surgery. These patients often also receive medication to lower GH levels. Radiation therapy is given in divided doses over 4 to 6 weeks. This acromegaly treatment lowers GH levels by about 50% over 2 to 5 years.
Patients monitored for more than 5 years show significant further improvement. Radiation treatment for acromegaly can cause a gradual loss of production of other pituitary hormones with time. Loss of vision and brain injury, which have been reported, are very rare complications of radiation treatments.
Acromegaly Treatment: Summary
No single acromegaly treatment is effective for all patients. Treatment for acromegaly should be tailored to the individual patient's characteristics, such as age and tumor size. If the tumor has not yet invaded surrounding brain tissues, removal of the pituitary adenoma by an experienced neurosurgeon is usually the first choice. After surgery, a patient must be monitored for a long time for increasing GH levels.
If surgery does not return hormone levels to normal, or if a relapse occurs, a doctor will usually begin additional medicines for acromegaly treatment. The first choice should be bromocriptine because it is easy to administer; octreotide is the second alternative. With both medications, long-term treatment is necessary because their withdrawal can lead to rising GH levels and tumor re-expansion.
Radiation therapy is generally used for patients whose tumors are not completely removed by surgery, for patients who are not good candidates for surgery because of other health problems, and for patients who do not respond adequately to surgery and medication.