Outcome of gamma knife radiosurgery in 82 patients with acromegaly: Correlation with initial hypersecretion

Context: Because surgical and medical therapies of acromegaly all have specific limitations, radiotherapy has been used as an adjunctive strategy. Stereotactic radiosurgery has not yet been widely evaluated. Objective: The objective was to perform an analysis of long-term hormonal effects and tolerance of gamma knife radiosurgery. Design: Eighty-two patients were prospectively studied over a decade, with a mean follow-up of 49.5 months. Setting: All patients were treated at the Department of Functional Neurosurgery of Marseille, France. Patients: The patients included 82 with active acromegaly, of whom 63 had previous transsphenoidal surgery. Intervention: Intervention included radiosurgery using the Leksell Gamma Unit B model. Main Outcome Measures: Remission was diagnosed when mean GH levels were less than 2 ng/ml and IGF-I was normal for age off somatostatin agonists (at least 3 months). Results: Seventeen percent of the patients were in remission without any treatment. Twenty-three percent previously ...