title: Effect of preoperative use of long-acting octreotide on growth hormone secreting pituitary adenoma and transsphenoidal surgery.
abstract: OBJECTIVE
  To investigate whether somatostatin analog octreotide long acting release (LAR) shrinks growth hormone (GH) secreting adenomas, and improves the results of subsequent transsphenoidal surgery.
  
  
  METHODS
  Seventeen previously untreated active acromegalic patients with pituitary adenomas were treated with LAR (30 mg intramuscular injection every 28 days) for 3 months prior to transsphenoidal surgery. Clinical reaction, mean GH secretion, and tumor volume were measured under basal conditions and after LAR treatment.
  
  
  RESULTS
  Presurgical treatment improved acromegaly symptoms and induced a significant reduction of GH under the 5 ng/mL limit in microadenoma (P < 0.05), while only 18.2% (2/11) in macroadenoma. Meanwhile, tumor shrinkage occurred in 58.8% (10/17) patients, with 1 case in the microadenoma group. All marked shrinkage (> 25%) occurred in the macroadenoma group. Statistical analysis showed tumor shrinkage caused by LAR was greater in macroadenoma group than that in microadenoma group (P < 0.05). During operation, adenoma was soft in 15 cases, with the exception of 2 cases in which the soft tumor was divided by fibrous septa, but all tumor removal was smooth.
  
  
  CONCLUSIONS
  A short term administration of preoperative LAR may induce a significant decrease in GH-secretion level and adenoma volume. Presurgical use of octreotide LAR improves surgical results especially in macroadenomas.
authors.affiliation: Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730.
authors.forename: Jian
authors.initials: J
authors.lastname: Yin
authors.forename: Chang-bao
authors.initials: CB
authors.lastname: Su
authors.forename: Zhi-qin
authors.initials: ZQ
authors.lastname: Xu
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.forename: Wen-bin
authors.initials: WB
authors.lastname: Ma
authors.forename: Wei
authors.initials: W
authors.lastname: Tao
authors.forename: Zhong
authors.initials: Z
authors.lastname: Yang
authors.forename: Xue-wei
authors.initials: XW
authors.lastname: Xia
mesh_terms: D000172:Acromegaly / Q000188:drug therapy*; D000236:Adenoma / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D007016:Hypophysectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D011300:Preoperative Care
chemical_list: D018931:Antineoplastic Agents, Hormonal; D003692:Delayed-Action Preparations; D019382:Human Growth Hormone; D015282:Octreotide