Postoperative treatment of clinically nonfunctioning pituitary adenomas with dopamine agonists decreases tumour remnant growth

Abstract

Dopamine agonist therapy is associated with a decreased prevalence of residual tumour enlargement in patients with nonfunctioning pituitary adenomas, particularly when treatment is instituted before tumour remnant growth is detected.

Dopamine agonist therapy of clinically non-functioning pituitary macroadenomas. Is there a role for 123I-epidepride dopamine D2 receptor imaging?

“…Therefore, bromocriptine therapy has not been advocated on a routine basis. Better, but still variable, results have been reported on the treatment with the nonergot DA agonist quinagolide and the specific DA agonist cabergoline (20,23,26,27,34,35,39). The heterogeneity of responses to treatment has been attributed to the different pattern and level of expression of dopamine receptor subtypes in the individual tumors, as well as to possible alterations in the receptor-related signal transduction pathway (10,27,38).…”

“…In 61% of patients with tumor remnant growth during the course of routine follow-up growth stabilized or decreased with this therapy (26). In contrast, tumor size remained stable in only 38% and increased in the remaining 62% of untreated subjects (26). Pivonello and co-workers have shown significant tumor shrinkage in five out of nine patients treated with the DA agonist cabergoline for 12 months (27).…”

“…In the present study, we were unable to demonstrate superiority of cabergoline over quinagolide or vice versa in the therapy of NFPAs. Greenman and co-workers have shown that tumor mass decreased or remained stable in 90% of patients in whom DA treatment was initiated upon detection of residual tumor on postoperative MRI (26). In 61% of patients with tumor remnant growth during the course of routine follow-up growth stabilized or decreased with this therapy (26).…”

“…The use of dopamine (DA) agonists has been previously explored as a treatment alternative for NFPA (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Greenman and co-workers have shown that postoperative DA treatment resulted in a decrease or stabilization of tumor mass in 90% of patients in contrast to 2 and 5 years re-growth rates of 30 and 70% in untreated patients respectively (26). In 61% of patients with tumor remnant growth during the course of routine follow-up, growth stabilized or decreased with this therapy (26).…”

“…Greenman and co-workers have shown that postoperative DA treatment resulted in a decrease or stabilization of tumor mass in 90% of patients in contrast to 2 and 5 years re-growth rates of 30 and 70% in untreated patients respectively (26). In 61% of patients with tumor remnant growth during the course of routine follow-up, growth stabilized or decreased with this therapy (26). In contrast, tumor size remained stable only in 38% and increased in the remaining 62% of untreated subjects (26).…”