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首页> 外文期刊>Journal of Endocrinological Investigation: Official Journal of the Italian Society of Endocrinology >GH/IGF-I normalization and tumor shrinkage during long-term treatment of acromegaly by lanreotide.
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GH/IGF-I normalization and tumor shrinkage during long-term treatment of acromegaly by lanreotide.

机译：GH/IGF-I normalization and tumor shrinkage during long-term treatment of acromegaly by lanreotide.

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New depot somatostatin analogs such as lanreotide-slow release (LAN) represent a significant improvement in the medical treatment of acromegaly. Seventy-three consecutive acromegalic patients, treated by LAN, were evaluated in a retrospective monocentric study. Sixteen were excluded from further evaluation due to combined treatment with dopamine agonist drugs, early LAN withdrawal for persistence of headache, or gastrointestinal side-effects. Fifty-seven patients (aged 20-82 years, 16 males) were thus evaluated. Thirty-two patients had been previously treated by neurosurgery (Tx) and/or radiotherapy (Rx). After washout, LAN (30 mg) was administered im at 10-14-day intervals. Time intervals between injections were then individually tailored to normalize IGF-I levels. LAN was administered for 12 (6-36) median (range) months. GH and IGF-I levels decreased from 13 (7-20) median (interquartile) microg/l to 3.2 (1.7-6.2) microg/l (p<0.0001) and from 780 (596-1000) microg/l to 264 (180-530) microg/l (p<0.000001), respectively. Seven patients were resistant to treatment. Among the 50 sensitive patients, GH levels fell below 2.5 microg/l in 52 (and below 1 microg/l in 18), IGF-I levels normalized in 72 and both results were obtained in 46. IGF-I values normalized in 87 of patients treated every 14 days, in 100 every 21-28 days, in 69 every 10 days and in 22 every 7 days. No different control of GH/IGF-I hypersecretion was evidenced between patients previously treated or not by Tx and/or Rx. Patients with the lowest basal hormonal levels and those over 55 years showed greater responsiveness (both p<0.05). The maintenance of LAN schedule up to 18 months determined a further suppression (p=0.04 for IGF-I). A reduction of tumor size was shown in 60 of evaluated patients (6/10). HbA1c slightly increased in 42 of patients and gallstones were observed in 16. LAN is a very effective tool in the treatment of acromegaly: its chronic administration normalizes GH/IGF-I levels in most patients, shrinks the tumor in a high percentage of patients and seems to control hormonal hypersecretion as primary treatment as well as neurosurgery.

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