Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Eur J Endocrinol. 2012 Apr;166(4):585-92. doi: 10.1530/EJE-11-0853. Epub 2012 Jan 16.
To assess the influence of long-acting somatostatin analogs (SSTA) after initial pituitary surgery on long-term health-related quality of life (HR-QoL) in relation to disease control in patients with acromegaly.
This is a cross-sectional study in two tertiary referral centers in The Netherlands.
One hundred and eight patients with acromegaly, in whom transsphenoidal (n=101, 94%) or transcranial (n=7, 6%) surgery was performed. Subsequently, 46 (43%) received additional radiotherapy and 41 (38%) were on postoperative treatment with SSTA because of persistent or recurrent disease at the time of study. All subjects filled in standardized questionnaires measuring HR-QoL. Disease control at the time of study was assessed by local IGF1 SDS.
IGF1 SDS were slightly higher in patients treated with SSTA in comparison with patients without use of SSTA (0.85±1.52 vs 0.25±1.21, P=0.026), but the percentage of patients with insufficient control (IGF1 SDS >2) was not different (17 vs 9%, P=0.208). Patients using SSTA reported poorer scores on most subscales of the RAND-36 and the acromegaly QoL and on all subscales of the multidimensional fatigue inventory-20. A subgroup analysis in patients with similar IGF1 levels (SSTA+, n=26, IGF1 SDS 0.44±0.72 vs SSTA-, n=44, IGF1 SDS 0.41±0.65) revealed worse scores on physical functioning, physical fatigue, reduced activity, vitality, and general health perception across all HR-QoL questionnaires in patients treated with SSTA.
QoL is impaired in association with the need for prolonged postoperative therapy by SSTA in patients with acromegaly despite similar IGF1 levels.
评估初诊垂体手术后长效生长抑素类似物（SSTA）对肢端肥大症患者疾病控制相关的长期健康相关生活质量（HR-QoL）的影响。
这是荷兰两个三级转诊中心的横断面研究。
108 例肢端肥大症患者，经蝶窦（n=101，94%）或经颅（n=7，6%）手术治疗。随后，46 例（43%）接受了额外的放疗，41 例（38%）因研究时疾病持续或复发而接受了术后 SSTA 治疗。所有受试者均填写了测量 HR-QoL 的标准化问卷。研究时的疾病控制通过局部 IGF1 SDS 评估。
与未使用 SSTA 的患者相比，使用 SSTA 的患者 IGF1 SDS 略高（0.85±1.52 vs 0.25±1.21，P=0.026），但控制不足（IGF1 SDS >2）的患者比例无差异（17% vs 9%，P=0.208）。使用 SSTA 的患者在 RAND-36 的大多数子量表和肢端肥大症 QoL 以及多维疲劳量表-20 的所有子量表上的评分都较差。在 IGF1 水平相似的患者亚组分析中（SSTA+，n=26，IGF1 SDS 0.44±0.72 vs SSTA-，n=44，IGF1 SDS 0.41±0.65），SSTA 治疗的患者在所有 HR-QoL 问卷中的身体功能、身体疲劳、活动减少、活力和总体健康感知方面的评分都较差。
尽管 IGF1 水平相似，但肢端肥大症患者需要长期术后 SSTA 治疗会导致生活质量受损。
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