Introduction: Somatostatin analogues (SSAs) are used in the treatment of somatotropinomas. Actually, the use of these drugs in clinically non-functioning pituitary adenomas (NFPA) is raised. The aim of the study is to assess the effectiveness of SSA therapy in both groups.
Materials and methods: 40 acromegalic patients and 22 patients with NFPA were treated with SSA for the total therapy duration up to 10 years. Hormonal profile, dynamics of tumour size changes, ophthalmic exam with assessement of visual field, somatostatin receptor scintigraphy, immunohistochemistry of somatostatin receptor subtypes of operated tumours as well as patients quality of life and undesirable effects were analysed.
Results: The significant decrease of GH and IGF1 concentrations was noticed in 95% of acromegalic patients (16 recurrent tumours and 24 primary tumours). The complete normalisation of hormone levels was observed in 57.5% of patients. The evaluation of the tumours size in MRI revealed their significant decrease in 40% of acromegalic patients including 81% of primary adenomas. The quality of life was improved in almost all patients. Two patients developed cholelithiasis with indication to cholecystectomy. Considering the patients with NFPA the stabilisation of tumour size and visual field was observed in 68% while the reduction of tumour size was noticed in 9% of cases. 23% of patients revealed an increase of adenoma size regarding the reoperation.
Conclusions: SSAs are effective in the treatment of acromegaly. In patients with NFPA the effectiveness of SSA is much lower. However, pharmacotherapy with SSA in the cases of NFPA allows the stabilisation of the disease and can be considered as an alternative for the next neurosurgeries.