TY - JOUR
T1 - Multidisciplinary management of difficult/aggressive growth-hormone pituitary neuro-endocrine tumors
AU - Bianchi, Antonio
AU - Chiloiro, Sabrina
AU - Giampietro, Antonella
AU - Gaudino, Simona
AU - Calandrelli, Rosalinda
AU - Mazzarella, Ciro
AU - Caldarella, Carmelo
AU - Rigante, Mario
AU - Gessi, Marco
AU - Lauretti, Liverana
AU - De Marinis, Laura
AU - Olivi, Alessandro
AU - Pontecorvi, Alfredo
AU - Doglietto, Francesco
N1 - Funding Information:
The authors would like to thank Dr. Patrick Moore for language editing, and proofreading.
Publisher Copyright:
Copyright © 2023 Bianchi, Chiloiro, Giampietro, Gaudino, Calandrelli, Mazzarella, Caldarella, Rigante, Gessi, Lauretti, De Marinis, Olivi, Pontecorvi and Doglietto.
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
KW - acromegaly
KW - aggressive pituitary adenoma
KW - growth hormone
KW - multidisciplinary
KW - pituitary adenoma
KW - pituitary neuro-endocrine tumor
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U2 - 10.3389/fendo.2023.1123267
DO - 10.3389/fendo.2023.1123267
M3 - Short survey
C2 - 37206441
AN - SCOPUS:85159904600
SN - 1664-2392
VL - 14
JO - Frontiers in Endocrinology
JF - Frontiers in Endocrinology
M1 - 1123267
ER -