Preoperative Treatment of Growth Hormone-Producing Pituitary Adenoma with Continuous Subcutaneous Infusion of Octreotide

Endocrine Journal

KIYOTO ASHIZAWA³  NAOKATA YOKOYAMA³  MISA TAMURA³  TAN TOMINAGA³  NOBUKO SERA³  MASATAKA UETANI²  TAKESHI KIRIYAMA³  ERI EJIMA³  SHIGENOBU NAGATAKI³  YASUYO ABE³  AKIO KUWAYAMA¹ 

[1] Department of Neurosurgery, National Nagoya Hospital;Department of Radiology, Nagasaki University School of Medicine;The First Department of Internal Medicine, Nagasaki University School of Medicine

关键词: Acromegaly;    Octreotide;    Continuous subcutaneous infusion;    GH;    Tumor shrinkage;   

DOI  :  10.1507/endocrj.45.269

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(24)Cited-By(1)Preoperative therapy with octreotide, a long-acting somatostatin analog, suppresses GH hypersecretion, shrinks GH-producing tumors and leads to an improvement in subsequent surgical remission in acromegalic patients. A continuous infusion of octreotide has demonstrated more persistent suppression of GH secretion than intermittent injections, and only a few studies were reported on the effect of the tumor shrinkage with a continuous infusion of a small dose of octreotide. We therefore investigated the preoperative effects of small doses of octreotide (120-240μg/day) administered continuously (with a subcutaneous infusion pump) over a short period (2 or 4 weeks) in nine untreated acromegalic patients. Octreotide therapy resulted in suppression of serum GH and IGF-1 concentrations in 8 out of 9 patients and reduction in pituitary tumor size measured by MRI in all patients (by 7.9 to 38.5%). In particular, considerable reduction in tumor size (more than 20%) occurred in 6 of 9 patients. In three patients assessed serially throughout the preoperative period, reduction in tumor size was noted within only one week after the start of octreotide therapy and reduction rate more than 20% was obtained within the first two weeks. In one patient, suprasellar tumor expansion totally disappeared after such therapy. Our results indicate that short-term continuous subcutaneous infusion of a small dose of octreotide results in not only inhibition of GH hypersecretion but also shrinkage of tumor size prior to surgery.

【 授权许可】

Unknown