Growth Hormone-Secreting Tumor Shrinkage after 3 Months of Octreotide-Long-Acting Release Therapy Predicts the Response at 12 Months
| Autor: | Silvia Savastano, Rosario Pivonello, Ludovica F S Grasso, Mariano Galdiero, Gaetano Lombardi, Renata S. Auriemma, Annamaria Colao |
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| Přispěvatelé: | Colao, Annamaria, Pivonello, Rosario, Auriemma, RENATA SIMONA, Galdiero, Mariano, Savastano, Silvia, L. F. S., Grasso, Lombardi, Gaetano |
| Rok vydání: | 2008 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty Time Factors Antineoplastic Agents Hormonal Endocrinology Diabetes and Metabolism Clinical Biochemistry Octreotide Long acting release Peptide hormone Growth hormone Biochemistry octreotide-LAR Endocrinology Predictive Value of Tests Internal medicine Acromegaly Humans Medicine Aged Retrospective Studies Aged 80 and over business.industry Biochemistry (medical) Tumor shrinkage Middle Aged Stepwise regression Prognosis medicine.disease Tumor Burden Treatment Outcome Somatostatin Delayed-Action Preparations Female GH-secreting pituitary tumor Growth Hormone-Secreting Pituitary Adenoma business Follow-Up Studies medicine.drug |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 93:3436-3442 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jc.2008-0424 |
| Popis: | OBJECTIVE: The objective of the study was to evaluate whether tumor shrinkage or GH and IGF-I levels achieved after 3 months predicted tumor shrinkage after 12 months of octreotide-long-acting release (LAR) treatment. PATIENTS: Patients included 67 patients with de novo acromegaly (33 women, 34 men; aged 20-82 yr) receiving LAR at a dose of 20 mg every 28 d for 3 months. Final LAR dose was 10 mg every 28 d in 4, 30 mg every 28 d in 39, 20 mg every 28 d in 24 patients. DESIGN: The design of the study was analytical, observational, open, and retrospective. OUTCOME MEASURES: Percent change in GH and IGF-I levels and tumor volume after 3 and 12 months of therapy was measured. Stepwise regression and receiving-operator characteristics analysis were used to calculate the optimal cutoff to predict 12 months tumor shrinkage at 12 months. RESULTS: The percent tumor shrinkage after 12 months was significantly correlated with GH, IGF-I, and tumor volume at 3 months and with the dose of LAR administered between 3 and 12 months. There was no correlation with gender, age, baseline GH levels and tumor volume. In a stepwise regression analysis, percent tumor shrinkage after 3 months was the best predictor of tumor shrinkage after 12 months (t = 5.92; P < 0.0001), followed by GH levels after 3 months (t = 2.86; P = 0.0056). To predict 50% or greater tumor shrinkage after 12 months, the best cutoff point of tumor shrinkage at 3 months was 22.1% [sensitivity (95% confidence interval) = 85.5% (71.2-95.4); specificity = 83.3% (65.3-94.3)], whereas that of GH levels after 3 months was 7.8 microg/liter [sensitivity = 70.3% (53.0-84.1); specificity = 93.3% (79.0-99.0)]. CONCLUSION: Tumor shrinkage achieved after 3 months of LAR treatment at 20 mg/28 d predicted tumor shrinkage at 12 months, provided that dosages were changed according to individual patients requirement. |
| Databáze: | OpenAIRE |
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