Cabergoline Effectivenes in Patients with Clinically Nonfunctioning Pituitary Adenomas

Presentation Number: SAT-0654
Date of Presentation: June 21st, 2014

Rafael Loch Batista*1, Nina de Castro Musolino2, Clarissa Groberio Borba3, Valter Angelo Sperling Cescato4, Gilberto Ochman Silva5 and Malebranche Cunha Neto3
1Hospital das Clinicas, FMUSP, Brazil, 2Hospital das Clínicas, FMUSP, São Paulo, Brazil, 3Hospital das Clínicas, FMUSP, 4HC FMUSP, Sao Paulo, Brazil, 5USP

Abstract

Introduction: Clinically Nonfunctioning Pituitary Adenomas (NFPA) are approximately 30% of all pituitary tumors. The treatment of choice is surgical resection. Although surgery can relieve symptoms related tumor compression, complete surgical resection is not frequent and radiotherapy is required in many cases. The role of dopamine agonists have not yet been well established in NFPA and better designed studies are lacking to prove its effectiveness Last year, we present preliminary data from this study, with 67 patients.. Here we present the final results of this project, including more than 100 patients.

Objective: To evaluate the useful of cabergoline in patients with NFPA who had evident residual tumor after transsphenoidal (TS) surgery in reducing and /or maintain a stable tumor rest.

Methods: We compared two groups of NFPA patients who presented residual tumor in a MRI performed six months after surgery: 52 patients treated by cabergoline - 3.5mg/week (A) and 49 patients followed without cabergoline (B). No patients were treated by irradiation before or during the follow-up. All patients were evaluated every 6 months with MRI for 12 months. Change of tumor volume bigger than 15% were considering significant. Statistical analysis was performed using the statistical program SOFA.

Results: The MRI in group A showed stabilization of residual tumor in 71,15% (37/52) and tumor reduction in 21,15% (11/52) of patients, while tumor progression was observed in 7,69% (7,69%). In group B, stabilization was observed at 81.63% (40/49), reduction in 4,08% (2/49) and growth in 14.28% (7/49) of patients. Statistical difference between groups A and B was obtained regarding tumor reduction - 21,15% (A) vs. 4,08% (B), p < 0.01 - and tumor progression - 7,69% (A) vs. 14.28% (B) p = 0.037 - with no difference in the stabilization of residual tumor (p = 0.44).

Conclusions: Cabergoline, after TS surgery, was useful in reducing or stabling residual tumor in significant number of NFPA patients in a 12 months follow up. The use of cabergoline was associated with greater tumor shrinkage and no medication use (conservative treatment) was associated with higher rates of growth of the tumor rest.

 

Nothing to Disclose: RLB, NDCM, CGB, VASC, GOS, MC