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Mullan K et al. – The authors have found that a significant number of patients (25/57) achieved persistently normal IGF–1 free of adjunctive treatment for at least 1 year, after external pituitary irradiation for acromegaly. This demonstrates that, with time, external pituitary irradiation achieves a normal IGF–1 in significant numbers of patients with acromegaly, thus obviating the need for life–long expensive medical therapy. For each patient this benefit has to be weighed against the possibility of new hypopituitarism as a result of the treatment. Any decision to use external pituitary irradiation is easier in the context of pre–existent hypopituitarism.

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