| Abstract | OBJECTIVE: To review our experience with cabergoline, a D2-selective dopamine agonist, for the treatment of giant prolactinomas. DESIGN: A retrospective case series; descriptive statistics. METHODS: The study group included 12 men aged 24-52 years (mean 39.2 years) treated for giant prolactinoma at our centers from 1997 to 2006. Cabergoline was started at a dose of 0.5 mg/three times a week and progressively increased as necessary to up to 7 mg/week. Patients were followed by hormone measurements, sellar magnetic resonance imaging, and visual examinations. RESULTS: In ten patients, cabergoline served as first-line therapy. The other two patients had previously undergone transsphenoidal partial tumor resection because of visual deterioration. Mean serum prolactin level before treatment was 14,393 +/- 14,579 ng/ml (range 2047-55,033 ng/ml; normal 5-17 ng/ml). Following treatment, levels normalized in ten men within 1-84 months (mean, 25.3 months) and decreased in the other two to 2-3 times of normal. Tumor diameter, which measured 40-70 mm at diagnosis, showed a mean maximal decrease of 47 +/- 21%; response was first noted about 6 months after the onset of treatment. Nine patients had visual field defects at diagnosis; vision returned to normal in three of them and improved in five. Testosterone levels, initially low in all patients, normalized in eight. There were no side effects of treatment. CONCLUSION: Cabergoline therapy appears to be effective and safe in men with giant prolactinomas. These findings suggest that cabergoline should be the first-line therapy for aggressive prolactinomas, even in patients with visual field defects. |
| Authors | Ilan Shimon, Carlos Benbassat, Moshe Hadani
(Affiliation: Institute of Endocrinology and Metabolism, Rabin Medical Center, Beilinson Hospital, Petah Tiqwa, Israel. ilanshi at clalit.org.il)
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| Journal | European journal of endocrinology / European Federation of Endocrine Societies
(Eur J Endocrinol)
Vol. 156
Issue 2
Pg. 225-31
(Feb 2007)
ISSN: 0804-4643 England |
| PMID | 17287412
(Publication Type: Journal Article)
|
| Chemical References |
- Antineoplastic Agents
- Ergolines
- cabergoline
- Prolactin
|
| Topics |
- Adult
- Antineoplastic Agents
(administration & dosage)
- Ergolines
(administration & dosage)
- Follow-Up Studies
- Humans
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Pituitary Neoplasms
(complications, drug therapy, pathology)
- Prolactin
(blood)
- Prolactinoma
(complications, drug therapy, pathology)
- Retrospective Studies
- Time Factors
- Treatment Outcome
- Vision Disorders
(etiology, pathology)
- Visual Fields
|
