Unresolved issues: radiosurgery versus radiation therapy; medical suppression of growth hormone production during radiosurgery; and endoscopic surgery versus microscopic surgery

摘要

This issue of Neurosurgical Focus contains important reviews of several aspects of acromegaly. Three themes are emphasized in at least 3 contributions: the attributes of radiosurgery compared with conventional fractionated radiation therapy for patients with residual tumor after surgery; the use of medical therapy to suppress tumor production of growth hormone (GH) during radiosurgery; and the "pure" endoscopic approach for surgery. The authors of these reports already emphasize much of what I have to say here. However, certain arguments, arguments that have been recently proposed and widely avowed, albeit without solid validation by scientific or clinical studies, justify further discussion here.