Evaluation of surgery and radiosurgery for acromegaly: A review of efficacy, complications, and follow-up

Abstract

Background: Acromegaly is a rare disease caused by an over-increase in growth hormone (GH) and insulin-like growth factors. If left untreated, acromegaly is associated with many complications and increased mortality. The three modalities of treatment for this disease are surgery, pharmacotherapy, and radiotherapy. Another treatment option is stereotactic radiosurgery (SRS), which is used as an adjunct and alternative treatment in patients with acromegaly who are not suitable options for surgery. Methods: The present study is a review study conducted by searching the databases of Elsevier, PubMed, Springer, and Wiley, and using the keywords of acromegaly, treatment, transsphenoidal surgery, and radiosurgery. Fifteen studies, which had been performed between 2010 and 2021, were selected for review. Results: The results of these studies indicated that the use of SRS (LINAC SRS and GKRS) after surgery and medical treatment, before surgery and during radiotherapy improve biochemical and endocrine control and the quality of life of patients. However, due to some side effects of these treatments, it is necessary to conduct further studies in this field. Conclusion: All three modalities of treatment would be effective in acromegaly if used with appropriate indication in right sequence. Keywords: Pituitary Neoplasms, Pituitary Gland, Radiotherapy, Radiosurgery, Acromegaly