title: Preoperative lanreotide treatment improves outcome in patients with acromegaly resulting from invasive pituitary macroadenoma.
abstract: OBJECTIVE
  To investigate whether 3 months' preoperative treatment with lanreotide improved outcome in newly diagnosed patients with acromegaly resulting from invasive pituitary macroadenoma.
  
  
  METHODS
  After baseline evaluation, untreated patients were randomized to undergo direct transsphenoidal  surgery or lanreotide treatment (30 mg via intramuscular injection every 2 weeks, increased to 30 mg/week at week 8 if growth hormone nadir > 2.5 μg/l), for 3 months prior to surgery. Tumour shrinkage following lanreotide treatment was analysed. Cure was evaluated at 3 months postsurgery  by measuring growth hormone and insulinlike growth factor-1 (IGF-1) levels.
  
  
  RESULTS
  Preoperative lanreotide treatment significantly reduced mean tumour size. Growth hormone and IGF-1 levels were lower in the pretreatment group than in the direct surgery group at 3 months postsurgery. According  to combined growth hormone and IGF-1 levels, significantly more patients were cured by trans-sphenoidal surgery in the pretreatment group compared with the direct surgery group (11 of 24 and five of 25 patients, respectively).
  
  
  CONCLUSIONS
  Lanreotide treatment for 3 months before trans-sphenoidal  surgery effectively reduced tumour size, and improved surgical cure rate, in newly diagnosed patients with acromegaly resulting from invasive pituitary macroadenoma.
authors.affiliation: Department of Neurosurgery, Fengxian Branch of Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Z-Q
authors.initials: ZQ
authors.lastname: Li
authors.forename: Z
authors.initials: Z
authors.lastname: Quan
authors.forename: H-L
authors.initials: HL
authors.lastname: Tian
authors.forename: M
authors.initials: M
authors.lastname: Cheng
mesh_terms: D000172:Acromegaly / Q000188:drug therapy*; D000236:Adenoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I