Therapeutic Effect Of Cabergoline On The Treatment Of Bromocriptine-Resistant Or Intolerant Prolactinoma

OBJECTIVE:To investigate the therapeutic effect and tolerability of cabergoline in patients with prolactinoma who are resistant or intolerant to bromocriptine.Materials and Methods:This study collected 46 patients with prolactinoma who were treated with neurological surgery at the First Affiliated Hospital of Soochow University and treated with a regular dose of bromocriptine for drug resistance or intolerance.They were divided into two groups according to their resistance to bromocriptine and their tolerance.The first group was bromocriptine-resistant group,a total of 36 patients,and the second group was bromocriptine intolerance group,a total of 10 patients.All patients had a full-scale examination of the head MRI and pituitary before treatment,and have been diagnosed with prolactinoma.All patients were treated with bromocriptine and were resistant or intolerant to bromocriptine.Serum prolactin levels and head MRI were reviewed periodically during treatment with cabergoline.All patients were treated with cabergoline,and the starting dose of cabergoline was 0.5 mg once a week,once a week,and 4 nights.After one month of treatment,the serum prolactin level was reviewed,and the dose of cabergoline was adjusted according to the level of prolactin.The minimum dose that can maintain the serum prolactin level at the normal level was adjusted as a maintenance dose,and the treatment was maintained for a long time.All patients were regularly reviewed for serum PRL levels every month during treatment,and the head MRI was reviewed every six months to understand the size of the tumor.RESULTS:Of the 36 patients in the bromocriptine-resistant group,35 patients had normal PRL levels after treatment with cabergoline.The tumors were reduced by>50%and the effective rate was 97.2%.Among them,26 patients were completely eliminated,accounting for 72.22%of the treatment.And among the 35 patients with visual visual field impairment,their visual field of vision improved significantly after treatment.One of the patients had no significant decrease in serum PRL level after 39 months of treatment with cabergoline.The tumor size did not decrease significantly,and the visual field of vision did not improve significantly.The prolactinoma patients were considered to be resistant to both bromocriptine and cabergoline.In the bromocriptine intolerance group,all patients had a normal range of serum prolactin levels after treatment with cabergoline.Except for one of the patients who could not undergo head MRI,the remaining 9 patients underwent head MRI after treatment.The tumors have disappeared and the treatment effective rate is 100%.None of the 10 patients had side effects that caused the patient to be unable to take the drug for a long time,showing good tolerance to cabergoline.Conclusion:Cabergoline has a good therapeutic effect on bromocriptine-resistant prolactinoma,and it has less side effects and is well tolerated.