Therapeutic effect of bromocriptine on prolactinoma with different types_West China Medical Journal

Authors：

 QIE Yuanwei , LI Wenpeng , DENG Liyun , XIAO Yong

Department of Endocrinology, Yaan People’s Hospital, Yaan, Sichuan 625000, P. R. China;

Corresponding author：

QIE Yuanwei, Email: doctor_qyw@163.com

Keywords：

Prolactinoma; Bromocriptine; Clinical manifestation; Treatment effect

DOI：

10.7507/1002-0179.201805173

Video：

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ObjectiveTo explore the clinical characteristics of different types of prolactinoma and the therapeutic effect of bromocriptine.MethodsThe medical records of patients with prolactinoma treated by bromocriptine from January 2010 to December 2016 were retrospectively analyzed, and the patients were followed up.ResultsA total of 106 cases of prolactinoma were included, in whom 67 were microprolactinomas, 31 were macroprolactinomas, and 8 were giant prolactinoma. There were differences in the distributions of gender and age, prolactin level, clinical manifestations and the effective dose of bromocriptine among the three groups (P<0.05). After the treatment of bromocriptine, the level of serum prolactin was restored to normal in 61 cases in microprolactinoma group, 26 cases in macroprolactinoma group and 6 cases in giant prolactioma group. For improvement of the main symptoms, there were 63 patients in microprolactinoma group, 27 in macroprolactinoma group and 6 in giant prolactioma group. Furthermore, the shrink or disappearance was achieved in 28 patients in microprolactinoma group, 23 in macroprolactinoma group, and 8 in giant prolactioma group. The statistical results showed no significant difference in normal prolactin level and improvement of symptoms among the three groups (P>0.05), but the reduction of tumor volume were statistically different (P<0.05).ConclusionsMicroprolactinomas and macroprolactinomas are mostly seen in childbearing-aged women with main manifestations of menstrual disorders and lactation, while giant prolactinomas are mostly seen in middle-aged men, with main manifestations of headaches and visual field disorders. Bromocriptine has a good effect on prolactin adenomas with various sizes. Therefore bromocriptine should be the first choice for different types of prolactinomas.

Citation： QIE Yuanwei, LI Wenpeng, DENG Liyun, XIAO Yong. Therapeutic effect of bromocriptine on prolactinoma with different types. West China Medical Journal, 2018, 33(6): 703-708. doi: 10.7507/1002-0179.201805173 Copy

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8.	Wong A, Eloy JA, Couldwell WT, et al. Update on prolactinomas. Part 1: clinical manifestations and diagnostic challenges. J Clin Neurosci, 2015, 22(10): 1562-1567.
9.	Bloomgarden E, Molitch ME. Surgical treatment of prolactinomas: cons. Endocrine, 2014, 47(3): 730-733.
10.	Molitch ME. Management of medically refractory prolactinoma. J Neurooncol, 2014, 117(3): 421-428.
11.	王友伟, 马驰原. 多巴胺受体激动剂治疗泌乳素瘤的机制及研究进展. 中华神经外科疾病研究杂志, 2013, 12(3): 286-288.
12.	Webster J, Piscitelli G, Polli A, et al. A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline Comparative Study Group. N Engl J Med, 1994, 331(14): 904-909.
13.	Zárate A, Saucedo R, Basurto L. The best approach to treat prolactinoma. Gac Med Mex, 2004, 140(5): 567-569.
14.	Molitch ME. Pharmacologic resistance in prolactinoma patients. Pituitary, 2005, 8(1): 43-52.
15.	Vasilev V, Daly AF, Vroonen L, et al. Resistant prolactinomas. J Endocrinol Invest, 2011, 34(4): 312-316.
16.	Oh MC, Aghi MK. Dopamine agonist-resistant prolactinomas. J Neurosurg, 2011, 114(5): 1369-1379.

1. Glezer A, Bronstein MD. Prolactinomas. Endocrinol Metab Clin North Am, 2015, 44(1): 71-78.
2. Kars M, Souverein PC, Herings RM, et al. Estimated age- and sex-specific incidence and prevalence of dopamine agonist-treated hyperprolactinemia. J Clin Endocrinol Metab, 2009, 94(8): 2729-2734.
3. 罗雪珍, 林金芳. 高泌乳素血症对女性的不良影响. 实用妇产科杂志, 2016, 32(7): 483-484.
4. 韩冲, 潘源, 丁学华, 等. 重视泌乳素腺瘤的药物治疗. 中华内分泌外科杂志, 2014, 8(3): 240-242.
5. Mann WA. Treatment for prolactinomas and hyperprolactinaemia: a lifetime approach. Eur J Clin Invest, 2011, 41(3): 334-342.
6. Maiter D, Delgrange E. Therapy of endocrine disease: the challenges in managing giant prolactinomas. Eur J Endocrinol, 2014, 170(6): 213-227.
7. Melmed S, Casanueva FF, Hoffman AR, et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab, 2011, 96(2): 273-288.
8. Wong A, Eloy JA, Couldwell WT, et al. Update on prolactinomas. Part 1: clinical manifestations and diagnostic challenges. J Clin Neurosci, 2015, 22(10): 1562-1567.
9. Bloomgarden E, Molitch ME. Surgical treatment of prolactinomas: cons. Endocrine, 2014, 47(3): 730-733.
10. Molitch ME. Management of medically refractory prolactinoma. J Neurooncol, 2014, 117(3): 421-428.
11. 王友伟, 马驰原. 多巴胺受体激动剂治疗泌乳素瘤的机制及研究进展. 中华神经外科疾病研究杂志, 2013, 12(3): 286-288.
12. Webster J, Piscitelli G, Polli A, et al. A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline Comparative Study Group. N Engl J Med, 1994, 331(14): 904-909.
13. Zárate A, Saucedo R, Basurto L. The best approach to treat prolactinoma. Gac Med Mex, 2004, 140(5): 567-569.
14. Molitch ME. Pharmacologic resistance in prolactinoma patients. Pituitary, 2005, 8(1): 43-52.
15. Vasilev V, Daly AF, Vroonen L, et al. Resistant prolactinomas. J Endocrinol Invest, 2011, 34(4): 312-316.
16. Oh MC, Aghi MK. Dopamine agonist-resistant prolactinomas. J Neurosurg, 2011, 114(5): 1369-1379.

West China Medical Journal

Therapeutic effect of bromocriptine on prolactinoma with different types

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