Multidisciplinary management of difficult/aggressive growth-hormone pituitary neuro-endocrine tumors.
acromegaly
aggressive pituitary adenoma
growth hormone
multidisciplinary
pituitary adenoma
pituitary neuro-endocrine tumor
Journal
Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782
Informations de publication
Date de publication:
2023
2023
Historique:
received:
13
12
2022
accepted:
13
03
2023
medline:
22
5
2023
pubmed:
19
5
2023
entrez:
19
5
2023
Statut:
epublish
Résumé
Growth Hormone-secreting adenomas exhibits variable biological behavior and heterogeneous natural history, ranging from small adenomas and mild disease, to invasive and aggressive neoplasms with more severe clinical picture. Patients not cured or controlled after neurosurgical and first-generation somatostatin receptor ligands (SRL) therapy could require multiple surgical, medical and/or radiation treatments to achieve disease control. To date, no clinical, laboratory, histopathological, or neuroradiological markers are able to define the aggressiveness or predict the disease prognosis in patients with acromegaly. Therefore, the management of these patients requires careful evaluation of laboratory assessments, diagnostic criteria, neuroradiology examinations, and neurosurgical approaches to choose an effective and patient-tailored medical therapy. A multidisciplinary approach is particularly useful in difficult/aggressive acromegaly to schedule multimodal treatment, which includes radiation therapy, chemotherapy with temozolomide and other, recent emerging treatments. Herein, we describe the role of the different members of the multidisciplinary team according to our personal experience; a flow-chart for the therapeutic approach of difficult/aggressive acromegaly patients is proposed.
Identifiants
pubmed: 37206441
doi: 10.3389/fendo.2023.1123267
pmc: PMC10189777
doi:
Substances chimiques
Growth Hormone
9002-72-6
Human Growth Hormone
12629-01-5
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1123267Informations de copyright
Copyright © 2023 Bianchi, Chiloiro, Giampietro, Gaudino, Calandrelli, Mazzarella, Caldarella, Rigante, Gessi, Lauretti, De Marinis, Olivi, Pontecorvi and Doglietto.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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