Influence of parasellar extension of macroprolactinomas defined by magnetic resonance imaging on their responsiveness to dopamine agonist therapy

Delgrange, Etienne; Duprez, Thierry; Maiter, Dominique

doi:10.1111/j.1365-2265.2006.02493.x

Cited by 53 publications

(25 citation statements)

References 29 publications

(43 reference statements)

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“…It has been demonstrated that DA-resistant patients tend to be younger males with larger or more invasive adenomas [31–33]. A recent study on macroprolactinomas in children and adolescents indicated that DA resistance is associated with higher PRL levels and larger tumor sizes, which are closely linked together [34].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Clinical Outcomes of Invasive Giant Prolactinomas after a Mean Ten-Year Followup

Cai

Lin

et al. 2016

International Journal of Endocrinology

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Objective. The aim of this study is to observe clinical outcomes after more than ten years of followup in a group of patients with invasive giant prolactinomas (IGPs) treated with dopamine agonists (DAs). Methods. Twenty-five patients met the criteria of IGPs, among which 16 patients primarily received bromocriptine (BRC) and the other nine had undergone unsuccessful microsurgery prior to BRC treatment. Results. After a mean follow-up period of 135.5 ± 4.7 months, the clinical symptoms in all patients improved by different degrees. Tumor volume was decreased by a mean of 98.6%, and the tumors of 19 patients had almost completely disappeared. The mean duration of treatment at maximal doses of BRC was 48.5 months. At the last follow-up visit, nineteen patients had normal PRL levels, and 14 of these patients had received the low-dose BRC treatment (at an average of 2.9 ± 0.3 mg/d). Younger patients < 25 years had a significantly higher rate of persistent hyperprolactinemia after long-term BRC treatment (p = 0.043). Conclusion. DAs are a first-line therapy for IGPs because they can effectively achieve long-term control in both shrinking tumor volume and normalizing the PRL level, and majority of patients need low-dose DA maintenance. Younger patients are prone to persistent hyperprolactinemia despite long-term DA treatment.

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Section: Discussionmentioning

confidence: 99%

Long-Term Clinical Outcomes of Invasive Giant Prolactinomas after a Mean Ten-Year Followup

Cai

Lin

et al. 2016

International Journal of Endocrinology

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“…Considering these findings, the prolactin normalization remains an important and easily assessable end-point. Up to now, dose adjustments or medication changes have been mainly guided by attempts to obtain normalization of the hormonal levels [2,14,15]. Radiotherapy may be performed for radiologic or biochemical resistance cases.…”

Section: Discussionmentioning

confidence: 99%

Bromocriptine Therapy for the Treatment of Invasive Prolactinoma: The Single Institute Experience

Park

Shin

2013

Brain Tumor Res Treat

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ObjectiveThe objective of this study was to describe and characterize the clinical course of treatment for invasive prolactinoma patients using bromocriptine.MethodsThe study group included 23 patients who were treated with bromocriptine for their invasive prolactinomas. Clinical histories, serum prolactin level and pituitary hormone assessments, tumor diameter and signal intensity on sella magnetic resonance imaging (MRI), visual field exams and the dosage of medications were reviewed for each patient.ResultsDuring 30 months (median, range 6-99) of follow-up period, 19 patients treated with bromocriptine alone achieved biochemical remission. Four patients changed the medication to cabergoline due to the adverse effects or observed resistance of bromocriptine treatment. All of five patients who had visual symptoms improved after the course of medication. Four surgically treated patients were not able to discontinue medication because they could not maintain biochemical remission state without medication. Multivariate analysis showed that decreased enhancement on the initial followed MRI after medication and longer follow-up periods were associated with higher radiologic response.ConclusionWe reassure that the dopamine agonist is safe and effective for the treatment of invasive pituitary adenomas. Meanwhile, surgery has a limited role on biochemical remission. Decreased enhancement on the initial follow-up MRI after medication may reflect the treatment response. Further study is required to validate the role of MRI or other factors on the actual prognosis.

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“…³ ñï³âàâò. ïîêàçàëè, ùî ïàðàñåëÿðíå ðîç-ïîâñþäaeåííÿ ìàêðîïðîëàêòèíîì çà äàíèìè ÌÐÒ ãîëîâíîãî ìîçêó ìîaeå áóòè ïðåäèêòîðîì íåãà-òèâíî¿ â³äïîâ³ä³ íà òåðàï³þ ÀÄ [59]. Ïîçèòèâíó â³äïîâ³äü íà òåðàï³þ ÀÄ áóëî â³äçíà÷åíî ó 90% âèïàäê³â äëÿ õâîðèõ ³ç íå³íâàç³éíèìè ìàêðî-ïðîëàêòèíîìàìè ³ ó 50% -ç ³íâàç³éíèìè àäåíî-ìàìè.…”

Section: сучасні погляди на діагностику та лікування пролактиномunclassified

“…Â³äïîâ³äíî ï³ä ö³ëêîâèòîþ ðåçèñòåíòí³ñòþ ðî-çóì³þòü â³äñóòí³ñòü áóäü-ÿêîãî åôåêòó â³ä ÀÄ, ï³ä ÷àñòêîâîþ -íåìîaeëèâ³ñòü äîñÿãíåííÿ íîð-ìîïðîëàêòèíåì³¿ àáî çìåíøåííÿ îá'ºìó ã³ïîô³-çà ìåíøå, í³ae íà 50%. Ðåçóëüòàòè êë³í³÷íèõ äîñë³äaeåíü ïîêàçàëè, ùî ðåçèñòåíòí³ñòü äî áðî-ìîêðèïòèíó òà êàáåðãîë³íó òðàïëÿºòüñÿ ïðèáëèç-íî ó 30% ³ 10-15% âèïàäê³â â³äïîâ³äíî [67].…”

Section: сучасні погляди на діагностику та лікування пролактиномunclassified

“…Ó õâîðèõ íà ìàêðîïðîëàêòèíîìè íîðìîïðîëàêòèíåì³¿ áóëî äîñÿãíóòî ó 46% ïàö³ºíò³â, ÿê³ îòðèìóâàëè ë³êó-âàííÿ áðîìîêðèïòèíîì, ³ ó 82% -êàáåðãîë³íîì [69]. Âèÿâëåíî òàêîae çâ'ÿçîê ì³ae ñòóïåíåì ³íâà-ç³¿ ïðîëàêòèíîìè ó êàâåðíîçíèé ñèíóñ ³ ðåçèñ-òåíòí³ñòþ äî òåðàï³¿ êàáåðãîë³íîì [70].…”

Section: сучасні погляди на діагностику та лікування пролактиномunclassified

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Modern trends in diagnostics and treatment of prolactinomas

Хижняк¹,

Микитюк²,

Gogitidze³

2013

CE&ES

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Influence of parasellar extension of macroprolactinomas defined by magnetic resonance imaging on their responsiveness to dopamine agonist therapy

Cited by 53 publications

References 29 publications

Long-Term Clinical Outcomes of Invasive Giant Prolactinomas after a Mean Ten-Year Followup

Long-Term Clinical Outcomes of Invasive Giant Prolactinomas after a Mean Ten-Year Followup

Bromocriptine Therapy for the Treatment of Invasive Prolactinoma: The Single Institute Experience

Modern trends in diagnostics and treatment of prolactinomas

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