肢端肥大症的药物治疗--当肿瘤大小很重要时:叙述性综述。

IF 1.6 4区 医学 Q4 CELL BIOLOGY
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引用次数: 0

摘要

肢端肥大症的药物治疗一般被定位为垂体腺瘤手术后的第二线治疗。随着治疗肢端肥大症的药物越来越多,种类也越来越丰富,我们对这些药物的有效性和安全性也有了更多的了解。已发表的关于药物治疗对肢端肥大症生化控制的影响的大量数据与全面探讨不同药物治疗模式下垂体瘤变化的出版物相对缺乏形成鲜明对比。在肢端肥大症治疗过程中,临床医生对 GH 和 IGF-I 水平的关注往往掩盖了对分泌 GH 腺瘤体积变化的评估。对过去二十年发表的研究进行仔细分析后发现,在使用任何现有药物治疗肢端肥大症的过程中,体细胞瘤体积都有可能增大或缩小。垂体瘤体积的变化可能源于腺瘤本身的生物学特性,与用药无关。因此,在对肢端肥大症患者进行治疗时,有必要在反复了解其临床、生化、病理和影像学特征的基础上,采取因人而异的方法。在这篇综述中,我们总结并评论了垂体瘤的大小如何受到目前所有治疗肢端肥大症药物的影响:第一代长效体泌素受体配体(奥曲肽 LAR 和 Lanreotide autogel)、第二代长效体泌素受体配体(帕司瑞奥肽 LAR)、培维索曼(PEG)和卡麦角林(CAB)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medical treatment of acromegaly – When the tumor size matters: A narrative review

Medical treatment of acromegaly is generally positioned as a second line of treatment after pituitary adenoma surgery. With the rising availability and variety of medications for acromegaly increases our understanding of their effectiveness and safety. Volume of the published data on the impact of medical therapy on biochemical control of acromegaly, contrasts a relative lack of publications which comprehensively address pituitary tumor alterations under different drug modalities. Assessment of changes in GH-secreting adenoma volume is often overshadowed by clinicians' focus on GH and IGF-I levels during acromegaly treatment. Close analysis of studies published in the last two decades, reveals that both an increase and decrease in somatotropinoma volume are possible during treatment with any of available drugs for acromegaly. Changes in pituitary tumor size may arise from the biological nature of adenoma itself, independently of the administered medications. Therefore, an individual approach is necessary in the treatment of patients with acromegaly, based on repeated insight to their clinical, biochemical, pathological and imaging characteristics. In this review, we summarize and comment how pituitary tumor size is affected by the treatment with all currently available drugs in acromegaly: long-acting somatostatin receptor ligands of the first generation (octreotide LAR and lanreotide autogel) and the second generation (pasireotide-LAR), as well as pegvisomant (PEG) and cabergoline (CAB).

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来源期刊
Growth Hormone & Igf Research
Growth Hormone & Igf Research 医学-内分泌学与代谢
CiteScore
3.30
自引率
0.00%
发文量
38
审稿时长
57 days
期刊介绍: Growth Hormone & IGF Research is a forum for research on the regulation of growth and metabolism in humans, animals, tissues and cells. It publishes articles on all aspects of growth-promoting and growth-inhibiting hormones and factors, with particular emphasis on insulin-like growth factors (IGFs) and growth hormone. This reflects the increasing importance of growth hormone and IGFs in clinical medicine and in the treatment of diseases.
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