These results suggest that gamma knife stereotactic radiosurgery may be more advantageous than conventional radiotherapy in the management of patients with residual acromegaly following surgery. Octreotide may be a reasonable alternative to surgery in selected patients with acromegaly. Octreotide may be appropriate in patients when it is unlikely that complete tumor removal will be achieved provided there is no visual compromise or other legitimate reason to proceed with surgery. Several studies have documented the efficacy of octreotide LAR in patients with acromegaly. The slow-release formulation reduces growth hormone and IGF1 levels similar to octreotide administered subcutaneously every eight hours.
Treatment also improves the clinical features of acromegaly.
The drug is well tolerated, but about one-quarter of patients develop gallstones and gallbladder sludge. A new test reliably distinguishes between patients with mild Cushing's syndrome, pseudo-Cushing's states, and normal individuals. This test seems useful in the evaluation of patients with suspected Cushing's syndrome that have normal or minimally elevated urinary steroid levels.