Endocrine Abstracts (2004) 7 P96

Results of different primary treatment procedures for acromegalic patients

N Ozbey, D Gjergji, A Sertkaya, R Kurt & S Molvalilar

Department of Medicine, Division of Endocrinology, Ýstanbul Medical Faculty, Ýstanbul University, Ýstanbul,Turkey.

In this study 32 acromegalic patients were retrospectively evaluated with respect to the results of different primary treatment procedures. Study group was composed of 32 acromegalic patients admitted to our department between the years 1979-2002 (20 females, 12 males; mean age 45.2 plus/minus 14.3 years, mean follow-up: 80.7 plus/minus 62.9 months). Patients were grouped according to the primary treatment approach: 1) Patients underwent pituitary surgery (n: 28; 21 macroadenoma, 7 microadenoma) 2) Patients underwent pituitary radiotherapy (n:2) 3) Patients given dopamine agonists (n:2). Pituitary surgery led to remission in 10 patients (6 microadenoma, 4 macroadenoma). Octreotide-LAR after surgery induced remission in the remaining patient with microadenoma. Octreotide LAR after surgery was given to 4 macroadenoma patients with active disease and led to remission in one patient (25 percent). The remaining 13 macroadenoma patients with active disease underwent pituitary radiotherapy after surgery. Octreotide-LAR was given to 8 out of those 13 patients with active disease after pituitary surgery+radiotherapy. Four out of those 8 patients (50 percent) were in remission after octreotide at the end of the follow-up period (mean: 90 plus/minus 76 months). Radiotherapy as a primary treatment approach induced remisson in one patient. The other patient was in remission after initiation of octreotide-LAR treatment. Dopamin agonists as the initial treatment were started in two patients with increased prolactin concentrations and induced remission with doses of bromocriptine 7.5 mg/day in one patient and cabergoline 1 mg/week for the other patient. These findings support the role of octreotide-LAR in challenging macroadenoma patients with active disease after pituitary surgery+radiotherapy.

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