Effect of preoperative use of long-acting octreotide on growth hormone secreting pituitary adenoma and transsphenoidal surgery.

Abstract

OBJECTIVE:

To investigate whether somatostatin analog octreotide long acting release (LAR) shrinks growth hormone (GH) secreting adenomas, and improves the results of subsequent transsphenoidal surgery.

METHODS:

Seventeen previously untreated active acromegalic patients with pituitary adenomas were treated with LAR (30 mg intramuscular injection every 28 days) for 3 months prior to transsphenoidal surgery. Clinical reaction, mean GH secretion, and tumor volume were measured under basal conditions and after LAR treatment.

RESULTS:

Presurgical treatment improved acromegaly symptoms and induced a significant reduction of GH under the 5 ng/mL limit in microadenoma (P < 0.05), while only 18.2% (2/11) in macroadenoma. Meanwhile, tumor shrinkage occurred in 58.8% (10/17) patients, with 1 case in the microadenoma group. All marked shrinkage (> 25%) occurred in the macroadenoma group. Statistical analysis showed tumor shrinkage caused by LAR was greater in macroadenoma group than that in microadenoma group (P < 0.05). During operation, adenoma was soft in 15 cases, with the exception of 2 cases in which the soft tumor was divided by fibrous septa, but all tumor removal was smooth.

CONCLUSIONS:

A short term administration of preoperative LAR may induce a significant decrease in GH-secretion level and adenoma volume. Presurgical use of octreotide LAR improves surgical results especially in macroadenomas.

• Authors: Jian Yin, Chang-bao Su, Zhi-qin Xu, Yi Yang, Wen-bin Ma, Wei Tao, Zhong Yang, Xue-wei Xia
• Journal: Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih (Chin Med Sci J) Vol. 20 Issue 1 Pg. 23-6 (Mar 2005) ISSN: 1001-9294 [Print] China
• PMID: 15844307 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents, Hormonal
• Delayed-Action Preparations
• Human Growth Hormone
• Octreotide

Topics

• Acromegaly (drug therapy)
• Adenoma (drug therapy, metabolism, surgery)
• Adult
• Antineoplastic Agents, Hormonal (administration & dosage, therapeutic use)
• Delayed-Action Preparations
• Female
• Human Growth Hormone (metabolism)
• Humans
• Hypophysectomy (methods)
• Male
• Middle Aged
• Octreotide (administration & dosage, therapeutic use)
• Pituitary Neoplasms (drug therapy, metabolism, surgery)
• Preoperative Care