Predictors of Tumor Shrinkage after Primary Therapy with Somatostatin Analogs in Acromegaly: A Prospective Study in 99 Patients

• DOI: 10.1210/jc.2005-2110
• Publication Date: 2006-03-14T21:43:25Z
• Authors: Annamaria Colao; Rosario Pivonello; Renata S. Auriemma; Francesco Briganti; Mariano Galdiero; Fabio Tortora; Ferdinando Caranci; Sossio Cirillo; Gaetano Lombardi
• Keywords: Adenoma; Adult; Male; Human Growth Hormone; tumor shrinkage; Acromegaly; tumor shrinkage; octreotide-LAR; lanreotide; Middle Aged; Octreotide; Peptides, Cyclic; octreotide-LAR; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Acromegaly; Humans; Female; Pituitary Neoplasms; lanreotide; Prospective Studies; Insulin-Like Growth Factor I; Somatostatin; Somatostatin; Acromegaly; MRI; Aged

Primary treatment with depot octreotide and lanreotide induces tumor shrinkage in newly diagnosed patients acromegaly.The objective of the study was to evaluate clinical predictors shrinkage.This an analytical, observational, open, prospective study.The included 99 patients: 13 microadenoma 86 macroadenoma (25 enclosed, 32 extrasellar, 29 invasive).Age, gender, estimated disease duration, body mass index, GH IGF-I levels, volume at diagnosis after 12 months were measured. Percentage GH, IGF-I, size changes from baseline also analyzed. Tumor scored as absent (+/- 0-25%), mild 25.1-50%), moderate 50.1-75%), or notable (75%).Sixty (60.6%) received im (20-30 mg every 28 d), 39 (39.4%) (60-90 d).Basal maximal diameter correlated age, levels. After months, levels controlled (</=2.5 microg/liter) 57.6%, 45.5%, both 42.4%. Shrinkage 22 (22.2%), 31 (31.1%), 30 (30.3%), 14 (14.1%). Two (not responding treatment) had a increase (by 34 31.2%, respectively). Basal posttreatment volumes highly (r = 0.79, P < 0.0001). At multistep regression analysis, percent decrease (t 2.6; 0.011) best predictor volume, followed by patients' age 2.1; 0.042) 2.0; 0.044).Most acromegaly (75.5%) 25% greater primary somatostatin analog therapy: significant occurred only 2.1% (uncontrolled during treatment). Best IGF-I.