ICEECE2012 Poster Presentations Endocrine tumours and neoplasia (112 abstracts)
Effect of dopamine agonists on the tumor size of prolactinomas: are suppressive doses different from those that normalize prolactin serum levels?
C. Sardella , C. Urbani , M. Lombardi , L. Manetti , C. Cosci , S. Brogioni , A. Marchello , E. Martino & F. Bogazzi
University of Pisa, Pisa, Italy.
Prolactin-secreting (PRL) adenomas are about 40% of all pituitary adenomas. The most important clinical symptoms of PRL excess are gonadal and sexual dysfunction as a result of tumor expansion in patients with macroadenomas. Medical therapy of prolactinomas relies on the use of dopamine agonists which induce normalization of PRL levels and shrinkage of the tumor mass in the majority of patients. The present study evaluated whether doses of dopamine agonist inducing normalization (2 ≤ PRL ≤ 20 ng/ml) or suppression (<2 ng/ml) of serum PRL levels may have a different effect on the tumor size. A total of 145 patients with prolactinomas treated with cabergoline were retrospectively evaluated. Seventy patients had microprolactinomas, 68 had macroprolactinomas and seven had giant invasive prolactinoma. The therapeutic dose of cabergoline was 1 mg/week in 48% of patients, 2 mg/week in 38% and between 2 and 5 mg/week in only 1%. The mean time of the treatment was about 70 month and the overall dosage of cabergoline was <1000 mg in 75% of patients. Tumor shrinkage occurred more in patients with macroprolactinomas than in those with microprolactinomas (38 vs 18%, P=0.016); particularly, 17.6% of the macroprolactinomas were reduced to microprolactinomas whereas tumor regression was observed in 20.6% of cases. No correlation between shrinking tumor and PRL levels (suppressed, normal or high (>20 ng/ml) was found. In conclusion, suppressive doses of cabergoline do not seem to be associated with an increased rate of tumor shrinkage.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
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Endocrine Abstracts
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