title: [Contemporary options and perspectives in the treatment of acromegaly].
abstract: Acromegaly, if untreated, leads to numerous complications and premature death of patients. In recent years, significant changes in the treatment of acromegaly were achieved. The surgical approach was innovated, what allows completely selective removal of most microadenomas without any damage of the pituitary and safe debulking of the tumor mass in macroadenomas. Radiosurgery took the first place among irradiation methods, in our conditions it is the irradiation by the Leksell gamma knife. It allows selective irradiation of an adenoma without damaging the surrounding tissue. However, its effect on the secretory activity of the adenoma remains to be long lasting. Before this effect is attained, it is necessary to suppress the secretory activity pharmacologically. The infrequently effective, but economically advantageous and comfortable for patients is cabergoline, which is administered in tablet form. If cabergolin is not efficient, depot injections of somatostatin analogues - octreotide LAR and lanreotide autogel or their combination with cabergoline are used. The most efficient but financially costly is pegvisomant, blocking the receptors for growth hormone. In our conditions it is reserved for patients unresponsive to other treatments. With sufficient dosage it is possible to normalize hormonal activity of acromegly in 95 % of patients. New forms of the drugs as octreotide implants, oral octreotide octreolin or a new blocker of growth hormone receptors ATL-1103 are in the development.
authors: Josef
authors: J
authors: Marek
mesh_terms: D000172:Acromegaly / Q000209:etiology / Q000628:therapy*; D000236:Adenoma / Q000150:complications / Q000601:surgery*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000077465:Cabergoline; D004873:Ergolines / Q000627:therapeutic use; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications / Q000601:surgery*; D019382:Human Growth Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D015282:Octreotide / Q000627:therapeutic use; D010456:Peptides, Cyclic / Q000627:therapeutic use; D016634:Radiosurgery; D011986:Receptors, Somatotropin / Q000037:antagonists & inhibitors*; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D004873:Ergolines; D010456:Peptides, Cyclic; D011986:Receptors, Somatotropin; C060347:lanreotide; D019382:Human Growth Hormone; D013004:Somatostatin; D000077465:Cabergoline; C406545:pegvisomant; D015282:Octreotide