The Observation Of Prolactinomas Treated With Varied Cumulative Doses Of Bromocriptine

Objective and Method:To observe and explore the therapeutic effect of different cumulative dose of bromocriptine on prolactinoma, we collected72cases of different types of prolactinoma, and divided them into3groups according to the tumor size and invasiveness, that is:Gaint Multidirectional Invasive Prolactinoma group (group A, GMIP group), macro prolactinoma group (group B), micro prolactinoma group (group C); And according to accumulated dose of certain period of treatment, we further divided them into three treatment levels:high doses (H), middle dose(M) and low dose(L). Then, we observed and analyzed the prolactin (PRL) decline rate and tumor shrinkage rate after treatment of each group and level. PRL observation time point as follows:1week,2weeks,3weeks and4weeks,8weeks and24weeks, and tumor shrinkage rate as follows:8weeks,24weeks and48weeks and96weeks. Inspection level a=0.05. Results:(1) In group C,patients with H level perform a significantly higher PRL drop rate than level M and L in the1,3,8weeks of treatment.(2) On level L, patients of group A perform a significantly higher PRL drop rate than group B and C in the1,2weeks of treatment while there was no significant difference between group B and C. On level M, patients of group A perform a significantly higher PRL drop rate than group B and C in the1,3weeks of treatment while group B perform a significantly higher PRL drop rate than group C in the3weeks of treatment. On level H, patients of group A perform a significantly higher PRL drop rate than group B and C in the1,8,24weeks of treatment while group B perform a significantly higher PRL drop rate than group C in the1,8weeks of treatment.(3) On level L and M, patients of group A perform a significantly higher tumor shrinkage rate than group B and C in the8weeks of treatment.(4) In group A, diameters of3different direction performd different speed of shrinkage in the first year of therapy. It appeared that the diameter from top to bottom of tumor lead in the shrinkage of GMIP.(5) With spearman rank correlation analysis, we find that tumor size, plasma prolactin levels and the numbers of direction of prolactinomas growth were positively correlated. Conclusion:(1) The doses of bromocriptine might affect the descent rate of plasma prolactin in the early stage of drug therapy of prolactinomas.(2) GMIP lead a higher PRL droup rate and tumor shrinkage rate within24weeks.(3) As the tumor is larger, its plasma prolactin will be higher, and it will be more likely to be invasive.(4) The diameter from top to bottom of tumor lead in the shrinkage of GMIP. Tumors that invade into the cavernous sinus is less likely to vanish in GMIP than other sorts of prolactinoma.