Male sex, the levels of prolactin, presence of hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to medical therapy
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Tipo de documento: | Dissertação |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://hdl.handle.net/10216/150323 |
Resumo: | Introduction - International guidelines recommend dopamine agonists as first-line treatment strategy for prolactinomas. Dopaminergic agonists allow the normalization of prolactin levels and the reduction of the tumor dimension. Despite its high efficacy, some prolactinomas are resistant to this therapy. Therefore, this retrospective study aims to identify differences between resistant and responder prolactinomas, to better identify them in clinical practice. Methods - Clinical, laboratory, and imaging characteristics of a cohort of 122 prolactinomas, followed at Centro Hospitalar Universitário de São João, were analyzed. Resistance was defined as the use of cabergoline in doses superior to 3 mg/week without lowering prolactin levels or tumor size. Results are presented as mean ± standard deviation and compared as appropriated, namely using a univariate and multivariate analysis. Results - We considered 114 patients as responders (23.7% male; age 21.5 ± 11.0 years; mean prolactin levels 147.0 ng/mL; 2.8% without visible lesion, 52.8% micro and 44.4% macroprolactinomas; suprasellar extension in 28.2%; infrasellar extension in 28.0% and parasellar extension in 30.1%) and 8 resistant (62.5% male; age 16.8 ± 12.9 years; mean prolactin levels 2430.0 ng/mL; all of them were macroprolactinomas and 87.5% presented extension in at least one of the 3 considered dimensions). Responders used medium doses of 6.6 ± 6.3 mg/day of bromocriptine and 1.1 ± 0.6 mg/week of cabergoline, while resistants used 16.3 ± 11.1 mg/day of bromocriptine and 5.4 ± 4.3 mg/week of cabergoline. One resistant patient was treated with temozolomide. All resistant had hypogonadism and presented more pituitary hypofunctions than responders. Conclusion - Male sex, higher prolactin levels, hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to dopaminergic agents. |
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Male sex, the levels of prolactin, presence of hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to medical therapyCiências médicas e da saúdeMedical and Health sciencesIntroduction - International guidelines recommend dopamine agonists as first-line treatment strategy for prolactinomas. Dopaminergic agonists allow the normalization of prolactin levels and the reduction of the tumor dimension. Despite its high efficacy, some prolactinomas are resistant to this therapy. Therefore, this retrospective study aims to identify differences between resistant and responder prolactinomas, to better identify them in clinical practice. Methods - Clinical, laboratory, and imaging characteristics of a cohort of 122 prolactinomas, followed at Centro Hospitalar Universitário de São João, were analyzed. Resistance was defined as the use of cabergoline in doses superior to 3 mg/week without lowering prolactin levels or tumor size. Results are presented as mean ± standard deviation and compared as appropriated, namely using a univariate and multivariate analysis. Results - We considered 114 patients as responders (23.7% male; age 21.5 ± 11.0 years; mean prolactin levels 147.0 ng/mL; 2.8% without visible lesion, 52.8% micro and 44.4% macroprolactinomas; suprasellar extension in 28.2%; infrasellar extension in 28.0% and parasellar extension in 30.1%) and 8 resistant (62.5% male; age 16.8 ± 12.9 years; mean prolactin levels 2430.0 ng/mL; all of them were macroprolactinomas and 87.5% presented extension in at least one of the 3 considered dimensions). Responders used medium doses of 6.6 ± 6.3 mg/day of bromocriptine and 1.1 ± 0.6 mg/week of cabergoline, while resistants used 16.3 ± 11.1 mg/day of bromocriptine and 5.4 ± 4.3 mg/week of cabergoline. One resistant patient was treated with temozolomide. All resistant had hypogonadism and presented more pituitary hypofunctions than responders. Conclusion - Male sex, higher prolactin levels, hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to dopaminergic agents.2023-05-232023-05-23T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttps://hdl.handle.net/10216/150323engMariana Pires Garciainfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-29T13:29:41Zoai:repositorio-aberto.up.pt:10216/150323Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T23:41:34.678518Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Male sex, the levels of prolactin, presence of hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to medical therapy |
title |
Male sex, the levels of prolactin, presence of hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to medical therapy |
spellingShingle |
Male sex, the levels of prolactin, presence of hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to medical therapy Mariana Pires Garcia Ciências médicas e da saúde Medical and Health sciences |
title_short |
Male sex, the levels of prolactin, presence of hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to medical therapy |
title_full |
Male sex, the levels of prolactin, presence of hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to medical therapy |
title_fullStr |
Male sex, the levels of prolactin, presence of hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to medical therapy |
title_full_unstemmed |
Male sex, the levels of prolactin, presence of hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to medical therapy |
title_sort |
Male sex, the levels of prolactin, presence of hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to medical therapy |
author |
Mariana Pires Garcia |
author_facet |
Mariana Pires Garcia |
author_role |
author |
dc.contributor.author.fl_str_mv |
Mariana Pires Garcia |
dc.subject.por.fl_str_mv |
Ciências médicas e da saúde Medical and Health sciences |
topic |
Ciências médicas e da saúde Medical and Health sciences |
description |
Introduction - International guidelines recommend dopamine agonists as first-line treatment strategy for prolactinomas. Dopaminergic agonists allow the normalization of prolactin levels and the reduction of the tumor dimension. Despite its high efficacy, some prolactinomas are resistant to this therapy. Therefore, this retrospective study aims to identify differences between resistant and responder prolactinomas, to better identify them in clinical practice. Methods - Clinical, laboratory, and imaging characteristics of a cohort of 122 prolactinomas, followed at Centro Hospitalar Universitário de São João, were analyzed. Resistance was defined as the use of cabergoline in doses superior to 3 mg/week without lowering prolactin levels or tumor size. Results are presented as mean ± standard deviation and compared as appropriated, namely using a univariate and multivariate analysis. Results - We considered 114 patients as responders (23.7% male; age 21.5 ± 11.0 years; mean prolactin levels 147.0 ng/mL; 2.8% without visible lesion, 52.8% micro and 44.4% macroprolactinomas; suprasellar extension in 28.2%; infrasellar extension in 28.0% and parasellar extension in 30.1%) and 8 resistant (62.5% male; age 16.8 ± 12.9 years; mean prolactin levels 2430.0 ng/mL; all of them were macroprolactinomas and 87.5% presented extension in at least one of the 3 considered dimensions). Responders used medium doses of 6.6 ± 6.3 mg/day of bromocriptine and 1.1 ± 0.6 mg/week of cabergoline, while resistants used 16.3 ± 11.1 mg/day of bromocriptine and 5.4 ± 4.3 mg/week of cabergoline. One resistant patient was treated with temozolomide. All resistant had hypogonadism and presented more pituitary hypofunctions than responders. Conclusion - Male sex, higher prolactin levels, hypopituitarism and suprasellar extension are predictors of prolactinomas resistance to dopaminergic agents. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-05-23 2023-05-23T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://hdl.handle.net/10216/150323 |
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https://hdl.handle.net/10216/150323 |
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eng |
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eng |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799135730340986880 |