Jadresic A
Departamento de Medicina, Facultad de Medicina, Universidad de Chile (Campus Occidente), Hospital San Juan de Dios, Santiago, Chile.
Rev Med Chil. 1997 Nov;125(11):1383-8.
Advances in medical treatment of prolactinomas and acromegaly in the last 20 years are analyzed. Dopaminergic drugs as bromocriptine, lisuride, pergolide and terguride successfully control hyperprolactinemia, reduce tumor size and cause clinical improvement. New long lasting medications with less adverse effects such as cabergoline, with oral weekly administration, and the repeatable monthly injectable form of bromocriptine (Parlodel LAR, Sandoz) may be the treatment of choice for prolactinomas. Dopaminergic medications are less effective in acromegaly. The higher doses required induce more collateral effects. An important step has been the incorporation of long lasting somatostatin analogues such as octreotide (for sbc use tid) intramuscular every 28 days injectable Sandostatin LAR and lanreotide SR (Somatuline, Ipsen Biotech), injectable every 10 to 14 days. Medical treatment of acromegaly is not, at the present, an alternative to surgery. However, the development of long lasting specific drugs may become, in the future, the choice or an alternative in the treatment of acromegaly.
分析了过去20年中泌乳素瘤和肢端肥大症医学治疗方面的进展。多巴胺能药物如溴隐亭、利舒脲、培高利特和替古瑞特可成功控制高泌乳素血症，缩小肿瘤大小并改善临床症状。新的长效药物副作用较少，如卡麦角林，每周口服一次，以及可重复每月注射的溴隐亭（帕罗西汀LAR，山德士公司）可能是泌乳素瘤的首选治疗方法。多巴胺能药物在肢端肥大症中的效果较差。所需的高剂量会引发更多副作用。一个重要进展是长效生长抑素类似物的应用，如奥曲肽（皮下注射，每日三次）、每28天肌肉注射一次的善宁长效注射剂以及每10至14天注射一次的兰瑞肽缓释剂（索马杜林，益普生生物技术公司）。目前，肢端肥大症的药物治疗并非手术的替代方法。然而，长效特效药物的研发未来可能会成为肢端肥大症治疗的选择或替代方法。
