open access

Vol 67, No 3 (2016)
Original papers
Published online: 2016-03-16
Submitted: 2015-09-18
Accepted: 2016-02-05
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An evaluation of the effects of somatostatin analogue therapy in non-functioning pituitary adenomas in comparison to acromegaly

Natalia Bożena Zawada, Jolanta Kunert-Radek, Marek Pawlikowski, Hanna Pisarek, Maciej Radek
DOI: 10.5603/EP.a2016.0043
·
Endokrynologia Polska 2016;67(3):292-298.

open access

Vol 67, No 3 (2016)
Original papers
Published online: 2016-03-16
Submitted: 2015-09-18
Accepted: 2016-02-05

Abstract

Introduction: Non-functioning pituitary adenomas (NFPA) are often diagnosed late as invasive macroadenomas. The surgical resection is usually incomplete and about 50% of patients require additional surgery. Recent data suggest that somatostatin analogues (SSA), so important in the pharmacotherapy of acromegaly, can also be effective in the management of NFPA.

Material and methods: We analysed data of patients who had been treated up to 10 years previously with SSA: 40 with acromegaly (23 — primary, 17 — recurrent tumours) and 22 with NFPA (4 — primary, 18 — recurrent tumours). Hormonal profile, dynamics of tumour size change, ophthalmic syndromes, somatostatin receptor (SSTR) scintigraphy, and immunohistochemistry of SSTR subtypes of operated tumours as well as side effects were investigated.

Results: Biochemical cure of acromegaly was achieved in 57.5% of patients, while reduction of tumour size was observed in 37% of patients and it was more frequent in not-operated cases. Regarding NFPA, stabilisation of tumour size was noticed in 68% of patients. Tumour shrinkage was reported in 9% of cases, but in 23% of the study group the adenoma size increased with indication for reoperation.

Conclusions: The efficacy of SSA in NFPA is much lower in comparison to their well-established effects in the treatment of acromegaly. Stabilisation of tumour size, which is observed in the majority of NFPA, is significantly more frequent in comparison to the natural history of untreated NFPA and our previous studies as well. Analysis of SSTR subtypes is an argument in favour of introduction of novel broad-spectrum SSA that may be more effective in the treatment of NFPA. Referring to acromegaly, adenoma size decrease was reported more frequently in primary therapy. Considering recurrent tumours better outcomes were achieved in patients who were pre-treated with SSA before planned surgery. (Endokrynol Pol 2016; 67 (3): 292–298)

Abstract

Introduction: Non-functioning pituitary adenomas (NFPA) are often diagnosed late as invasive macroadenomas. The surgical resection is usually incomplete and about 50% of patients require additional surgery. Recent data suggest that somatostatin analogues (SSA), so important in the pharmacotherapy of acromegaly, can also be effective in the management of NFPA.

Material and methods: We analysed data of patients who had been treated up to 10 years previously with SSA: 40 with acromegaly (23 — primary, 17 — recurrent tumours) and 22 with NFPA (4 — primary, 18 — recurrent tumours). Hormonal profile, dynamics of tumour size change, ophthalmic syndromes, somatostatin receptor (SSTR) scintigraphy, and immunohistochemistry of SSTR subtypes of operated tumours as well as side effects were investigated.

Results: Biochemical cure of acromegaly was achieved in 57.5% of patients, while reduction of tumour size was observed in 37% of patients and it was more frequent in not-operated cases. Regarding NFPA, stabilisation of tumour size was noticed in 68% of patients. Tumour shrinkage was reported in 9% of cases, but in 23% of the study group the adenoma size increased with indication for reoperation.

Conclusions: The efficacy of SSA in NFPA is much lower in comparison to their well-established effects in the treatment of acromegaly. Stabilisation of tumour size, which is observed in the majority of NFPA, is significantly more frequent in comparison to the natural history of untreated NFPA and our previous studies as well. Analysis of SSTR subtypes is an argument in favour of introduction of novel broad-spectrum SSA that may be more effective in the treatment of NFPA. Referring to acromegaly, adenoma size decrease was reported more frequently in primary therapy. Considering recurrent tumours better outcomes were achieved in patients who were pre-treated with SSA before planned surgery. (Endokrynol Pol 2016; 67 (3): 292–298)

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Keywords

somatostatin analogue therapy; non-functioning pituitary adenomas; acromegaly; somatostatin receptor scintigraphy; immunohistochemistry of somatostatin receptor subtypes

About this article
Title

An evaluation of the effects of somatostatin analogue therapy in non-functioning pituitary adenomas in comparison to acromegaly

Journal

Endokrynologia Polska

Issue

Vol 67, No 3 (2016)

Pages

292-298

Published online

2016-03-16

DOI

10.5603/EP.a2016.0043

Bibliographic record

Endokrynologia Polska 2016;67(3):292-298.

Keywords

somatostatin analogue therapy
non-functioning pituitary adenomas
acromegaly
somatostatin receptor scintigraphy
immunohistochemistry of somatostatin receptor subtypes

Authors

Natalia Bożena Zawada
Jolanta Kunert-Radek
Marek Pawlikowski
Hanna Pisarek
Maciej Radek

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