title: An evaluation of the effects of somatostatin analogue therapy in non-functioning pituitary adenomas in comparison to acromegaly.
abstract: BACKGROUND
  Non-functioning pituitary adenomas (NFPA) are often diagnosed late as invasive macroadenomas. The surgical resection is usually incomplete and about 50% of patients require additional surgery. Recent data suggest that somatostatin analogues (SSA), so important in the pharmacotherapy of acromegaly, can also be effective in the management of NFPA.
  
  
  METHODS
  We analysed data of patients who had been treated up to 10 years previously with SSA: 40 with acromegaly (23 - primary, 17 - recurrent tumours) and 22 with NFPA (4 - primary, 18 - recurrent tumours). Hormonal profile, dynamics of tumour size change, ophthalmic syndromes, somatostatin receptor (SSTR) scintigraphy, and immunohistochemistry of SSTR subtypes of operated tumours as well as side effects were investigated.
  
  
  RESULTS
  Biochemical cure of acromegaly was achieved in 57.5% of patients, while reduction of tumour size was observed in 37% of patients and it was more frequent in not-operated cases. Regarding NFPA, stabilisation of tumour size was noticed in 68% of patients. Tumour shrinkage was reported in 9% of cases, but in 23% of the study group the adenoma size increased with indication for reoperation.
  
  
  CONCLUSIONS
  The efficacy of SSA in NFPA is much lower in comparison to their well-established effects in the treatment of acromegaly. Stabilisation of tumour size, which is observed in the majority of NFPA, is significantly more frequent in comparison to the natural history of untreated NFPA and our previous studies as well. Analysis of SSTR subtypes is an argument in favour of introduction of novel broad-spectrum SSA that may be more effective in the treatment of NFPA. Referring to acromegaly, adenoma size decrease was reported more frequently in primary therapy. Considering recurrent tumours better outcomes were achieved in patients who were pre-treated with SSA before planned surgery. (Endokrynol Pol 2016; 67 (3): 292-298).
authors.forename: Natalia Bożena
authors.initials: NB
authors.lastname: Zawada
authors.affiliation: Department of Clinical Endocrinology, Chair of Endocrinology, Medical University of Lodz, Poland. jolanta.kunert-radek@umed.lodz.pl.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Kunert-Radek
authors.forename: Marek
authors.initials: M
authors.lastname: Pawlikowski
authors.forename: Hanna
authors.initials: H
authors.lastname: Pisarek
authors.forename: Maciej
authors.initials: M
authors.lastname: Radek
mesh_terms: D000172:Acromegaly / Q000188:drug therapy*; D000236:Adenoma / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D011877:Radionuclide Imaging; D013004:Somatostatin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013004:Somatostatin
keywords: acromegaly; immunohistochemistry of somatostatin receptor subtypes; non-functioning pituitary adenomas; somatostatin analogue therapy; somatostatin receptor scintigraphy