Role of stereotactic radiosurgery in the treatment of acromegaly.

Acromegaly is a rare, indolent disease due to overproduction of growth hormone. Surgery is identified as primary treatment, but has its limitation, thus frequently requiring alternate treatment options as adjunct to surgery. Stereotactic radiosurgery (SRS) has been used as adjuvant and alternate therapy in patients with inoperable or residual disease; or those not fit for surgery. It has shown reasonable results for treating macroadenoma and tumours invading cavernous sinuses with significant reduction in tumour size and durable endocrinological remission. Factors favouring better outcomes include time from last resection to SRS, older age, peri-procedural withdrawal of medication, higher margin and maximum dose.Hypopituitarism is the most common side effects and requires yearly screening. With the new advances in the field Fractionated-stereotactic radiosurgery and cyber-knife robotic radiosurgery have been introduced with promising preliminary results..