Minor tumour shrinkage in nonfunctioning pituitary adenomas by long-term treatment with the dopamine agonist cabergoline.
OBJECTIVE
The purpose of this study was to define safety and efficacy of medical therapy in the treatment of nonfunctioning pituitary tumours.


METHODS
We studied thirteen patients with a clinically nonfunctioning pituitary macroadenoma for response to cabergoline treatment for 1 year. Twelve/13 patients were already operated and had residual or recurrent tumours.


METHODS
We determined the outcome of treatment by visual perimetry, computed tumour size measurement in MRI and hormonal response (changes in pituitary function, reduction of alpha-subunit).


RESULTS
Seven/13 patients on cabergoline had a tumour shrinkage above 10% of the initial tumour volume. In 4 patients, this tumour shrinkage was correlated to an increasing distance of the tumour to the optic chiasm. Only 2/9 patients with visual field defects before therapy showed improvements in visual acuity under cabergoline. No significant side effects of the therapeutical regimens were observed. Neither LH and/or FSH expression in the tumour cells nor the reduction of the alpha-subunit serum levels by medical therapy was correlated to tumour shrinkage.


CONCLUSIONS
Given that these patients had advanced disease which makes it difficult to find significant therapeutic effects, medical therapy with potent dopamine agonists such as cabergoline may evolve as a novel therapeutic option in a subgroup of patients with clinically nonfunctioning tumours declining operation and radiotherapy.
Department of Internal Medicine III, University of Leipzig, Germany. Tobias.Lohmann@med1.imed.uni-erlangen.de
T
T
Lohmann
C
C
Trantakis
M
M
Biesold
S
S
Prothmann
S
S
Guenzel
R
R
Schober
R
R
Paschke
D000236:Adenoma / Q000188:drug therapy* / Q000473:pathology*; D000368:Aged; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004873:Ergolines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D011388:Prolactin / Q000097:blood; D016896:Treatment Outcome; D014792:Visual Acuity
D018491:Dopamine Agonists; D004873:Ergolines; D011388:Prolactin; D000077465:Cabergoline