Skip to main content
SpringerLink
Log in

Trattamento dell’acromegalia: attualità e prospettive

  • Published:
L’Endocrinologo Aims and scope

Riassunto

L’acromegalia è una malattia rara ma severa, il cui trattamento prevede un approccio integrato tra terapia medica, chirurgica e radioterapia. Tale schema terapeutico consente attualmente di curare la malattia nel 75% dei casi. In questo articolo, presenteremo le più recenti acquisizioni e le nuove prospettive nel trattamento terapeutico dell’acromegalia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Bibliografia

  1. Melmed S. Acromegaly. N Engl J Med 322: 966, 1990.

    Article  CAS  PubMed  Google Scholar 

  2. Nabarro JDN: Acromegaly. Clin Endocrinol 26: 481, 1980.

    Article  Google Scholar 

  3. Bengston BA, Eden S, Ernest I, Oden A, Sjogren B. Epidemiology and long-term survival in acromegaly: a study of 166 cases diagnosed between 1955 and 1984. Acta Med Scand 223: 327, 1988.

    Google Scholar 

  4. Jenkins PJ, Fairclough PD, Richards T, Lowe DG, et al. Acromegaly colonic polyps and carcinoma. Clin Endocrinol 47: 17, 1997.

    Article  CAS  Google Scholar 

  5. Melmed S, Ho K, Reichlin S, Thorner M. Recent advances in pathogenesis, diagnosis, and management of acromegaly. J Clin Endocrinol Metab 80: 3395, 1995.

    CAS  PubMed  Google Scholar 

  6. Colao A, Lombardi G. Growth-hormone and prolactin excess. Lancet 352: 1455, 1998.

    Article  CAS  PubMed  Google Scholar 

  7. Wright AD, Hill DM, Lowy C, Fraser TR. Mortality in acromegaly. Q J Med 34: 1, 1970.

    Google Scholar 

  8. Bates AS, Van’t Hoff W, Jones JM, Clayton RN. An audit of outcome of treatment in acromegaly. Q J Med 86: 293, 1993.

    CAS  PubMed  Google Scholar 

  9. Giustina A, Barkan A, Casanueva FF, et al. Criteria for cure of acromegaly: a consensus statement. J Clin Endocrinol Metab 85: 526, 2000.

    CAS  PubMed  Google Scholar 

  10. Ross DA, Wilson CB. Results of transsphenoidal microsurgery for growth hormone—secreting pituitary adenoma in a series of 214 patients. J Neurosurg 68: 854, 1988.

    Article  CAS  PubMed  Google Scholar 

  11. Fahlbusch R, Honegger J, Schott W, Buchfelder M. Results of surgery in acromegaly. In: Wass JAH, (ed.) Treating acromegaly. Bristol: J Endocrinol 84: 49, 1994.

  12. Laws ER Jr, Carpenter SM, Scheithauer BW, Randall RV. Long-term results of transsphenoidal surgery for the management of acromegaly. In: Robbins R, Melmed S, (eds.) Acromegaly: a century of scientific and clinical progress. Plenum Press, New York, 241, 1995.

    Google Scholar 

  13. Melmed S, Jackson I, Kleinberg D, Klibanski A. Current treatment guidelines for acromegaly. J Clin Endocrinol Metab 83: 2646, 1998.

    CAS  PubMed  Google Scholar 

  14. Fahlbusch R, Honegger J, Buchfelder M. Surgical management of acromegaly. Endocrinol Metab Clin North Am 21: 669, 1992.

    CAS  PubMed  Google Scholar 

  15. Diez JJ, Iglesias P. Current management of acromegaly. Exp Opin Pharmacother 1: 991, 2000.

    Article  CAS  Google Scholar 

  16. Diez JJ. Conceptos actuales en el diagnostico y tratamiento de la acromegalia. Rev Clin Esp 196: 622, 1996.

    CAS  PubMed  Google Scholar 

  17. Wass JAH, Sheppard MC. New treatments for acromegaly. J R Coll Physicians Lond 32: 113, 1998.

    CAS  PubMed  Google Scholar 

  18. Ahmed S, Elsheikh M, Stratton IM, Page RLC, Adams CBT, Wass JAH. Outcome of transsphenoidal surgery for acromegaly and its relationship to surgical experience. Clin Endocrinol (Oxf) 50: 561, 1999.

    Article  CAS  Google Scholar 

  19. Swcaringen B, Barker FG, Katznelson L, et al. Long-term mortality after transsphenoidal surgery and adjunctive therapy for acromegaly. J Clin Endocrinol Metab 83: 3419, 1998.

    Google Scholar 

  20. Jho HD, Carrau RL. Endoscopic endonasal transsphenoidal surgery: experience with 50 patients. Neurosurgical Focus 1: 1, 1996.

    Google Scholar 

  21. Jho HD, Carrau RL. Endoscopic endonasal transsphenoidal surgery: experience with 50 patients. J Neurosurg 87: 44, 1997.

    Article  CAS  PubMed  Google Scholar 

  22. Cappabianca P, Alfieri A, de Divitiis E. Endoscopic endonasal transsphenoidal approach to the sella: towards functional endoscopic pituitary surgery (FEPS). Minim Invas Neurosurg 41: 66, 1998.

    Article  CAS  Google Scholar 

  23. Cappabianca P, Alfieri A, Colao A, Ferone D, Lombardi G, de Divitiis E. Endoscopic endonasal transsphenoidal approach: an additional reason in support of surgery in the management of pituitary lesions. Skull Base Surg 9: 109, 1999.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Ciric I, Ragin A, Baumgartner C, Pierce D. Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery 40: 225, 1997.

    Article  CAS  PubMed  Google Scholar 

  25. Reddy K, Fewer D, West M. Complications of the transsphenoidal approach to the sellar lesions. Can J Neurol Sci 18: 463, 1991.

    CAS  PubMed  Google Scholar 

  26. Cappabianca P, Alfieri A, Colao A, et al. Endoscopic endonasal transsphenoidal surgery in recurrent and residual pituitary adenomas: technical note. Minim Invasive Neurosurg 43: 38, 2000.

    Article  CAS  PubMed  Google Scholar 

  27. Laws ER Jr. Comment to the article: Rodziewicz GS, Kelley RT, Kellman RM, Smith MV. Transnasal endoscopic surgery of the pituitary gland: technical note. Neurosurgery 39: 193, 1996.

    Article  Google Scholar 

  28. Eastman RC, Garden P, Roth J. Conventional supervoltage irradiation is an effective treatment for acromegaly J Clin Endocrinol Metab 48: 931, 1979.

    Article  CAS  PubMed  Google Scholar 

  29. Eastman RC, Garden P, Glatstein E, Roth J. Radiation therapy of acromegaly. Endocrinol Metab Clin North Am 21: 693, 1992.

    CAS  PubMed  Google Scholar 

  30. Barrande G, Pittino-Lungo M, Coste J, Ponvert D, Bertagna X, Luton JP, Bertherat J. Hormonal and metabolic effects of radiotherapy in acromegaly: long-term results in 128 patients follwed in a single center. J Clin Endocrinol Metab 85: 3779, 2000.

    Article  CAS  PubMed  Google Scholar 

  31. Biermasz NR, Dulken H, Roelfsema F. Long-term follow-up results of postoperative radioteraphy in 36 patients with acromegaly. J Clin Endocrinol Metab 85: 2476, 2000.

    Article  CAS  PubMed  Google Scholar 

  32. Powell JS, Wardlaw SL, Post KD, Freda PU. Outcome of radiotherapy for acromegaly using normalization of insulin-like growth factor I to define cure. J Clin Endocrinol Metab 85: 2068, 2000.

    CAS  PubMed  Google Scholar 

  33. Landolt AM, Haller D, Lomax N, Scheib S, Schubiger O, Siegfried J, Wellis G. Octreotide may act as a radioprotective agent in acromegaly. J Clin Endocrinol Metab 85: 1287, 2000.

    Article  CAS  PubMed  Google Scholar 

  34. Clarke SD, Woo Sy, Butler EB, et al. Treatment of secretory pituitary adenoma with radiation therapy. Radiology 188: 759, 1993.

    CAS  PubMed  Google Scholar 

  35. Jalali R, Brada M, Perks JR, Warrington AP, Traish D, Burchell L, McNairs H, Thomas GT, Robinson S, Johnston DG. Stereotactic conformal radiotherapy for pituitary adenomas: tecnique and preliminary experience. Clin Endocrinol 52: 695, 2000.

    Article  CAS  Google Scholar 

  36. Jones A. Radiation oncogenesis in relation to the treatment of pituitary tumours. Clin Endocrinol 35: 379, 1990.

    Article  Google Scholar 

  37. Colao A, Merola B, Ferone D, Lombardi G. Acromegaly. J Clin Endocrinol Metab 82: 2777, 1997.

    Article  CAS  PubMed  Google Scholar 

  38. Bengtsson BA, Eden S, Ernest I, Oden A, Sjogren B. Epidemiology and long-term survival in acromegaly: a study of 166 cases diagnosed between 1955 and 1984. Acta Med Scand 223: 327, 1988.

    Article  CAS  PubMed  Google Scholar 

  39. Jaffe CA, Barkan Al. Treatment of acromegaly with dopamine agonists. Endocrinol Metab Clin North Am 21: 713, 1992.

    CAS  PubMed  Google Scholar 

  40. Ciccarelli F, Miola C, Grottoli S, Avataneo T, Lancranjan I, Capanni F. Long-term therapy of patients with macroprolactinoma using repeatable injiectable bromocriptine. J Clin Endocrinol Metab 76: 484, 1993.

    CAS  PubMed  Google Scholar 

  41. Lombardi G, Colao A, Ferone D, et al. CV 205–502 treatment in therapy-resistant acromegalic patients. Eur J Endocrinol 132: 559, 1995.

    Article  CAS  PubMed  Google Scholar 

  42. Colao A, Ferone D, Marzullo P, et al. Effect of different dopaminergic agents in the treatment of acromegaly. J. Clin. Endocrinol. Metab 82: 518, 1997.

    Article  CAS  PubMed  Google Scholar 

  43. Abs R, Verhelst J, Maiter D, et al. Cabergoline in the treatment of acromegaly: a study in 64 patients. J Clin Endocrinol Metab 83: 374, 1998.

    Article  CAS  PubMed  Google Scholar 

  44. Scanlon MF. Dopamine agonists in the treatment of acromegaly. In: Wass JAH, (ed.) Treating acromegaly. Bristol Journal of Endocrinology?: 139, 1994.

  45. Lancranjan I, Burns C, Grass P, et al. Sandostatin LAR: pharmacokinetics, pharmacodynamics, efficacy and tolerability in acromegalic patients. Metabolism 44(Suppl 1): 18, 1995.

    Article  CAS  Google Scholar 

  46. Lancranjan I, Atkinson AB and the Sandostatin LAR Group. Result of European Multicentre Study with Sandostatin LAR in acromegalic patients. Pituitary 1: 105, 1999.

    Article  CAS  PubMed  Google Scholar 

  47. Heron I, Thomas F, Dero M, et al. Pharmacokinetics and efficacy of long-acting formulation of the new somatostatin analog BIM 23014 in patients with acromegaly. J Clin Endocrinol Metab 76(3): 721, 1993.

    CAS  PubMed  Google Scholar 

  48. Lamberts SWJ, Van Der Lely AJ, Hreder WW, Hofland LJ. Octreotide. N Engl J Med 334: 246, 1995.

    Google Scholar 

  49. Colao A, Cuocolo A, Marzullo P, et al. Effect of a 1-year treatment with octreotide on cardiac performance in patients with acromegaly. J Clin Endocrinol Metab 84: 17, 1999.

    Article  CAS  PubMed  Google Scholar 

  50. Ezzat S, Snyder PJ, Young WF, et al. Octreotide treatment of acromegaly: a randomized, multicenter study. Ann Intern Med 117: 711, 1992.

    Article  CAS  PubMed  Google Scholar 

  51. Newman CB, Melmed S, Snyder PJ, et al. Safety and efficacy of long term octreotide therapy of acromegaly: result of a multicenter trial in 103 patients-a clinical research center study. J Clin Endocrinol Metab 80: 2768, 1995.

    CAS  PubMed  Google Scholar 

  52. Lancrajan I, et al. Results of European study with sandostatin LAR in acromegalic patients. Pituitary 1: 105, 1999.

    Article  Google Scholar 

  53. Diez JJ. Lanreotida: una nueva opcion terapeutica en la acromegalia. Med Clin (Barc) 107: 247, 1996.

    Google Scholar 

  54. Turner HE, Valdivale A, Keenan J, Wass JAH. A comparison of lanreotide and octreotide LAR for treatment of acromegaly. Clin Endocrinol (Oxf) 51: 275, 1999.

    Article  CAS  Google Scholar 

  55. Newman CB, Melmed S, George A, et al. Octreotide as primary therapy for acromegaly. J Clin Endocrinol Metab 80: 2768, 1995.

    CAS  PubMed  Google Scholar 

  56. Gills JC, Noble S, Goa KL. Octreotide long-acting release (LAR): a review of its pharmacological properties and therapeutic use in the management of acromegaly. Drugs 53: 681, 1997.

    Article  Google Scholar 

  57. Anthony L, Johnson D, Hande K, Shaff M, Winn S, Krozely M, Oates J. Somatostatin analogue phase I trials in neuroendocrine neoplasm. Acta Oncol 32: 217, 1993.

    Article  CAS  PubMed  Google Scholar 

  58. Chen WY, Chen N, Yun J, Wagner TE, Kopchick JJ. In vitro and in vivo studies of antagonistic effects of human growth hormone analogs. J Biol Chem 269: 15892, 1994.

    CAS  PubMed  Google Scholar 

  59. Trainer PJ, Drake WM, Katznelson L, et al. Treatment of acromegaly with the growth hormone receptor antagonist pegvisomant. N Engl J Med 342: 1171, 2000.

    Article  CAS  PubMed  Google Scholar 

  60. Ferone D, Colao A, van der Lely A-J, Lamberts SWJ. Pharmacotherapy or surgery as primary treatment for acromegaly? Drugs & Aging 17: 81, 2000.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimenti di Endocrinologia ed Oncologia Molecolare e Clinica, Università degli Studi di Napoli “Federico II”, Via S. Pansini, 5, 80131, Napoli, Italia

    Annamaria Colao, Maria Luisa Landi, Mariagiovanna Filippella, Paolo Marzullo & Gaetano Lombardi

  2. Dipartimenti di Neurochirurgia, Università di Napoli “Federico II”, Napoli, Italia

    Paolo Cappabianca, Luigi M. Cavallo & Enrico de Divitiis

Authors
  1. Annamaria Colao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paolo Cappabianca
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Luisa Landi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mariagiovanna Filippella
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paolo Marzullo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Luigi M. Cavallo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Enrico de Divitiis
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gaetano Lombardi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Colao, A., Cappabianca, P., Landi, M.L. et al. Trattamento dell’acromegalia: attualità e prospettive. L’Endocrinologo 2, 99–109 (2001). https://doi.org/10.1007/BF03344393

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03344393

Search

Navigation