Effectiveness of long-term cabergoline treatment for giant prolactinoma: study of 12 men
Effectiveness of long-term cabergoline treatment for giant prolactinoma: study of 12 men
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DOI：
10.1530/eje-06-0646
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发表时间：
2007-02-01
影响因子：
5.8
通讯作者：
Hadani, Moshe
中科院分区：
文献类型：
--
作者：
Shimon, Ilan;Benbassat, Carlos;Hadani, Moshe
目的：回顾我们使用卡麦角林（一种 D2 选择性多巴胺激动剂）治疗巨大催乳素瘤的经验。设计：回顾性病例系列；描述性统计。方法：研究组包括 12 名年龄在 24-52 岁（平均 39.2 岁）的男性，他们于 1997 年至 2006 年在我们的中心接受了巨大催乳素瘤治疗。卡麦角林的剂量开始时为 0.5 毫克/每周 3 次，并根据需要逐渐增加至每周 7 毫克。对患者进行激素测量、鞍区磁共振成像和视力检查进行随访。结果：在 10 名患者中，卡麦角林作为一线治疗。另外两名患者此前因视力下降而接受过经蝶部分肿瘤切除术。治疗前平均血清催乳素水平为 14393 +/- 14579 ng/ml（范围 2047-55033 ng/ml；正常值 5-17 ng/ml）。治疗后，10 名男性的水平在 1-84 个月（平均 25.3 个月）内恢复正常，另外两名男性的水平下降至正常值的 2-3 倍。诊断时测量的肿瘤直径为 40-70 毫米，平均最大减小了 47 +/- 21%；治疗开始后约 6 个月首次出现反应。九名患者在诊断时存在视野缺陷：其中三名患者的视力恢复正常，五名患者的视力有所改善。所有患者的睾酮水平最初都很低，但在八名患者中恢复正常。治疗没有副作用。结论：卡麦角林治疗对于患有巨大泌乳素瘤的男性似乎是有效且安全的。这些发现表明，卡麦角林应该成为侵袭性催乳素瘤的一线治疗，即使是视野缺损的患者也是如此。
Objective: To review our experience with cabergoline, a D2-selective dopamine agonist, for the treatment of giant prolactinomas.Design: A retrospective case series; descriptive statistics.Methods: The study group included 12 men aged 24-52 years (mean 39.2 years) treated for giant prolactinoma at our centers from 1997 to 2006. Cabergoline was started at a dose of 0.5 mg/three times a week and progressively increased as necessary to up to 7 mg/week. Patients were followed by hormone measurements, sellar magnetic resonance imaging, and visual examinations.Results: In ten patients, cabergoline served as first-line therapy. The other two patients had previously undergone transsphenoidal partial tumor resection because of visual deterioration. Mean serum prolactin level before treatment was 14393 +/- 14579 ng/ml (range 2047-55033 ng/ml; normal 5-17 ng/ml). Following treatment, levels normalized in ten men within 1-84 months (mean, 25.3 months) and decreased in the other two to 2-3 times of normal. Tumor diameter, which measured 40-70 mm at diagnosis, showed a mean maximal decrease of 47 +/- 21%; response was first noted about 6 months after the onset of treatment. Nine patients had visual field defects at diagnosis: vision returned to normal in three of them and improved in five. Testosterone levels, initially low in all patients, normalized in eight. There were no side effects of treatment.Conclusion: Cabergoline therapy appears to be effective and safe in men with giant prolactinomas. These findings suggest that cabergoline should be the first-line therapy for aggressive prolactinomas, even in patients with visual field defects.