Endocrine Abstracts

The aim of this study was to evaluate our clinical experience in the treatment of acromegaly during 5-year follow-up period.

Methods: Seventeen acromegaly patients (11 women and six men) monitored during 5-year follow-up period. A level of GH of <2.5 ng/ml and the normal IGF range were considered as the criterion for remission. The GH level and IGF1 level were evaluated every 6 months, while magnetic resonance imaging was taken every year during follow-up period.

Results: All patients had growth in hands and feet and typical facial asymmetry in the beginning of the study. Six patients had diabetes mellitus (35%), four patients had hyperprolactinaemia (24%), two patients had hypothyroidism (12%) and five of patients had hypertension (29%). Visual field defect was in five patients (29%). Microadenomas founded in six patients and macroadenomas in 11 patients. Nine patients were treated by trans-sphenoidal surgery. One of them was cured, three patients developed postoperative pituitary deficiency. Two patients were treated by transcranial surgery, but not cured. One of them was treated by Gamma Knife radiosurgery and after that developed pituitary deficiency. Sixteen out of 17 acromegaly patients were treated by octreotide (six of patients as primary therapy and ten patients as secondary therapy after surgery). Biochemical remission was achieved in 12 of 16 patients (75%) who received octreotide treatment. Tumour size decrease was achieved in 54% of patients. The treatment was successful withdrawn at five patient (29%) without recurrence for 2–3 years follow-up. One patient passed away due to co-morbidities and at one patient treatment was cancelled due to kidney cancer. Only one patient (6.25%) who regularly used high dosage of octreotide has uncontrolled acromegaly.

Conclusion: Our findings demonstrated that octreotide LAR treatment successfully controlls clinical, biochemical and neuroradiological parameters.