title: Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa.
abstract: BACKGROUND
  The role of somatostatin analogues (SSTa) in the treatment of acromegaly.
  
  
  OBJECTIVE
  To evaluate the antihormonal and antitumour efficacy of long-term (up to 18 years) primary treatment with SSTa in patients with GH-secreting pituitary adenoma responsive to SSTa.
  
  
  METHODS
  An open, prospective, single-centre, clinical study.
  
  
  METHODS
  Thirty-six acromegalic patients, aged 17-75 years (postoral glucose tolerance test GH > 1 microg/l, increased IGF-1 for age and sex), were monitored in a single centre and treated with SSTa as first-line therapy. The mean pretreatment GH level was 13.5 +/- 3.1 microg/l, and IGF-1 (as a percentage of the value over the normal range) was 302 +/- 26%. The patients had macroadenoma (n = 25), microadenoma (n = 8) or empty sella turcica (n = 3). The mean duration of treatment was 8 years (range 3-18 years). Hormonal and morphological monitoring was undertaken after 6 months, and then the patients were followed annually.
  
  
  RESULTS
  After 1 year, the mean GH and IGF-1 levels had reduced considerably (GH: 2.4 +/- 0.3 microg/l; IGF-1; 174 +/- 14%, P < 0.01), and they continued to decrease over 10 years, with a mean GH level of 1.6 +/- 0.1 microg/l and IGF-1 of 123 +/- 18% (P = 0.02). GH < 2 microg/l, normal IGF-1, or both were observed in 25 (70%), 24 (67%) and 21 (58%) patients, respectively. The mean reduction in tumour volume was 43% (range 13-97%) and shrinkage > 20% was obtained in 21 patients (72%). SSTa treatment was well tolerated with few digestive or metabolic side-effects.
  
  
  CONCLUSIONS
  Long-term (up to 18 years) treatment with SSTa used as first-line therapy is effective from both an antihormonal and antitumour perspective, and is well tolerated in acromegalic patients.
authors.affiliation: Department of Endocrinology, CHU Rangueil, 31059 Toulouse, France.
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Maiza
authors.forename: Delphine
authors.initials: D
authors.lastname: Vezzosi
authors.forename: Maria
authors.initials: M
authors.lastname: Matta
authors.forename: Florence
authors.initials: F
authors.lastname: Donadille
authors.forename: Florence
authors.initials: F
authors.lastname: Loubes-Lacroix
authors.forename: Maxime
authors.initials: M
authors.lastname: Cournot
authors.forename: Antoine
authors.initials: A
authors.lastname: Bennet
authors.forename: Philippe
authors.initials: P
authors.lastname: Caron
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D013006:Growth Hormone / Q000097:blood*; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D010456:Peptides, Cyclic / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D011446:Prospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D018491:Dopamine Agonists; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D015282:Octreotide