Clinical and Laboratory Study of Acromegaly: Assessment Before and One Year After Treatment

Abstract

A clinical and laboratory study is described of 26 patients with acromegaly before and one year after treatment by one of the following methods: craniotomy with radiotherapy, cryosurgery, radioimplantation, or external irradiation. The correlation of clinical and laboratory data and their modification by treatment were used to compare the relative value of these methods of treatment. The plasma HGH concentration before treatment and its response to treatment did not correlate with other clinical and laboratory findings. We conclude that in many of these patients the plasma HGH level far surpasses that which would elicit a maximal biological response, and that HGH assays are not entirely satisfactory as an index of the severity of the disease or of the clinical and biochemical response to treatment. HGH assays provide the most sensitive diagnostic index of acromegaly, closely followed by hand volume determinations. The methods of treatment were compared for their effectiveness in reversing clinical abnormalities and in suppressing HGH secretion, for freedom from complications and for subsequent requirements for replacement therapy. Visual field defects regressed with each method of treatment studied. Patients with minor chiasmal compression need not be referred for open operation on this indication alone. In selected patients treated early in the course of the disease, external irradiation is superior to the other methods with which it has been compared.