BACKGROUND: Recent data has raised skepticism regarding the long-term effectiveness of radiotherapy (RxT) in @entity2012 and its role as an ancillary tool to neurosurgery (Tx). @entity1 : We evaluated 72 acromegalic @entity1 previously submitted to RxT. Data were discarded in 23 @entity1 , who were lost to follow-up, operated on after RxT or irradiated with techniques different from external conventional fractionated RxT. Among the remaining 49 (five with mixed GH-prolactin @entity652 ), 34 were irradiated after surgical failure and 15 as primary treatment. A second cycle of RxT was administered in two. RESULTS: (i) GH/ @entity442 . After a median follow-up of 14 years (range 3-41), normal age-matched @entity442 levels were reached in eight @entity1 (16%) after 10 years, and GH levels <2.5 microg/l in six (12%) after 9 years. The rate of persistently pathological hormonal levels was still 90% at 25 years. All @entity1 with GH/ @entity442 normalization had undergone irradiation without any antisecretory drug. Neither basal GH nor @entity5 size affected the outcome of RxT. In three @entity1 (6%) a relapse/worsening occurred. (ii) @entity5 size. @entity5 shrank after 8.5 years in 24 @entity1 (49%), in nine of whom during GH-suppressive treatment. @entity5 shrinkage was not predictive of hormonal normalization. (iii) Side-effects. @entity4614 was diagnosed in four @entity1 (selective in three and global in one) and GH deficiency in one. Three @entity1 had neurological side-effects and @entity1653 was shown in two @entity1 . CONCLUSION: RxT is unable to cure @entity2012 , because it seldom achieves hormonal normalization even after a very prolonged follow-up. Concomitant antisecretory treatment seems to counteract its effects. RxT can still play a role in those @entity1 with @entity5 remnants, because of its capacity to shrink @entity5 size.

Failure of radiotherapy in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'Tumor', 'large tumor'] @entity442 :: ('3479', 'Gene') :: ['IGF-I'] @entity2012 :: ('MESH:D000172', 'Disease') :: ['acromegaly'] @entity4614 :: ('MESH:D007018', 'Disease') :: ['Hypopituitarism'] @entity1653 :: ('MESH:D008579', 'Disease') :: ['meningioma'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenoma']
@entity2012 :: (MESH:D000172,Disease) :: ['acromegaly']
