阐明临床问题,为泌乳素瘤患者量身定制治疗方案

IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Min-Ho Lee, Jae Won Hong, Kyungwon Kim, Cheol Ryong Ku, Eun Jig Lee
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引用次数: 0

摘要

催乳素瘤是垂体神经内分泌腺瘤中最常见的一种,主要影响育龄妇女。与其他垂体瘤不同,传统的一线治疗方法是药物治疗而非手术治疗。之所以选择药物治疗,是因为多巴胺激动剂(DAs)疗效显著,通常能缩小肿瘤体积,并使大多数患者的泌乳素水平恢复正常。然而,这并不意味着没有改进的余地;治疗的持续时间和药物副作用常常导致患者的依从性问题。外科技术和分子生物学的最新进展为精准医疗的发展铺平了道路,使催乳素瘤的治疗策略更加灵活和个性化。本综述旨在通过关注以下几个关键因素,加强内分泌专家的临床决策和患者护理:泌乳素瘤敏感性的预测指标、经蝶鞍腺瘤切除术作为潜在一线治疗的临床特征和适宜性、长期使用泌乳素瘤药物后成功停药的决定因素、孕前/孕后和哺乳期的安全问题以及肿瘤侵袭性的决定因素。通过量身定制的疗法--以患者为中心的多学科方法--我们旨在改善催乳素瘤患者的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Elucidating Clinical Queries for Tailored Therapy in Patients with Prolactinoma.

Prolactinomas are the most prevalent type of pituitary neuroendocrine adenomas, primarily affecting women of reproductive age. Unlike other pituitary tumors, the first-line management has traditionally been pharmacological rather than surgical. This preference is due to the effectiveness of dopamine agonists (DAs), which typically reduce tumor size and normalize prolactin levels in most patients. However, this does not imply that there is no room for improvement; the duration of treatment and medication side effects often lead to compliance issues among patients. Recent advances in surgical techniques and molecular biology have paved the way for the development of precision medicine, allowing for more flexible and personalized treatment strategies for prolactinomas. This review aims to enhance clinical decision-making and patient care for endocrinologists by focusing on several key factors: predictive markers of DA sensitivity, clinical characteristics and suitability for transsphenoidal adenomectomy as a potential first-line treatment, factors determining the successful withdrawal of DAs after prolonged use, safety concerns during pre/post-pregnancy and breastfeeding, and determinants of tumor aggressiveness. Through tailored therapy-a patient-focused, multidisciplinary approach- we aim to improve the management of prolactinoma patients.

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来源期刊
Endocrinology and Metabolism
Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.60
自引率
5.90%
发文量
145
审稿时长
24 weeks
期刊介绍: The aim of this journal is to set high standards of medical care by providing a forum for discussion for basic, clinical, and translational researchers and clinicians on new findings in the fields of endocrinology and metabolism. Endocrinology and Metabolism reports new findings and developments in all aspects of endocrinology and metabolism. The topics covered by this journal include bone and mineral metabolism, cytokines, developmental endocrinology, diagnostic endocrinology, endocrine research, dyslipidemia, endocrine regulation, genetic endocrinology, growth factors, hormone receptors, hormone action and regulation, management of endocrine diseases, clinical trials, epidemiology, molecular endocrinology, neuroendocrinology, neuropeptides, neurotransmitters, obesity, pediatric endocrinology, reproductive endocrinology, signal transduction, the anatomy and physiology of endocrine organs (i.e., the pituitary, thyroid, parathyroid, and adrenal glands, and the gonads), and endocrine diseases (diabetes, nutrition, osteoporosis, etc.).
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