Background: Prolactinomas are rare in children and adolescents. As in adults, the dopamine agonists (DAs) are the treatment of choice in the majority of patients. However, at what point children should be taken off of therapy and what the recurrence risk of hyperprolactinemia is following treatment withdrawal is not well described. Objective: Our objective was to systematically review our experience with DA treatment withdrawal in children and adolescents with prolactinomas. Methods: A retrospect review of patients followed for prolactinomas during the last 12 years was conducted. Variables analyzed included age, gender, initial serum prolactin levels, tumor characteristics, cabergoline dose and results of treatment withdrawal. Clinical characteristics of patients who met eligibility criteria for DA withdrawal were compared with those who did not. Patients who underwent surgery were excluded. Results: Of 47 patients identified, 42 were included in the study. Of those, DA withdrawal was attempted in 13 (31%) and was initially successful in three (21%). Patients who did not meet eligibility criteria for treatment withdrawal had higher baseline prolactin levels (P=0.018) as well as larger (p=0.03) and more invasive (p=0.002) tumors. Conclusions: Less than half of our patients were eligible for DA treatment withdrawal and less than one fourth achieved remission of hyperprolactinemia following cessation of therapy. This suggests that the overall recurrence rate of prolactinomas in pediatric patients may be higher than has been reported in adults.


中文翻译：

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泌乳素瘤儿童停用多巴胺激动剂治疗的结果

背景：泌乳素瘤在儿童和青少年中很少见。与成人一样，多巴胺激动剂 (DAs) 是大多数患者的首选治疗方法。然而，儿童应该在什么时候停止治疗，以及治疗停止后高催乳素血症的复发风险是多少，并没有很好地描述。目的：我们的目的是系统评价我们在患有泌乳素瘤的儿童和青少年中停用 DA 治疗的经验。方法：对过去 12 年的泌乳素瘤患者进行了回顾性研究。分析的变量包括年龄、性别、初始血清催乳素水平、肿瘤特征、卡麦角林剂量和停药结果。将符合 DA 退出资格标准的患者的临床特征与不符合的患者进行比较。接受手术的患者被排除在外。结果：在确定的 47 名患者中，有 42 名被纳入研究。其中，13 人 (31%) 尝试了 DA 退出，最初在 3 人 (21%) 中取得了成功。不符合退出治疗资格标准的患者具有较高的基线催乳素水平 (P=0.018) 以及较大 (p=0.03) 和更具侵袭性 (p=0.002) 的肿瘤。结论：我们的患者中只有不到一半符合停用 DA 治疗的条件，在停止治疗后，不到四分之一的高催乳素血症得到缓解。这表明儿科患者泌乳素瘤的总体复发率可能高于已报道的成人。13 人 (31%) 尝试了 DA 退出，最初在 3 人 (21%) 中取得了成功。不符合退出治疗资格标准的患者具有较高的基线催乳素水平 (P=0.018) 以及较大 (p=0.03) 和更具侵袭性 (p=0.002) 的肿瘤。结论：我们的患者中只有不到一半符合停用 DA 治疗的条件，在停止治疗后，不到四分之一的高催乳素血症得到缓解。这表明儿科患者泌乳素瘤的总体复发率可能高于已报道的成人。13 人 (31%) 尝试了 DA 退出，最初在 3 人 (21%) 中取得了成功。不符合退出治疗资格标准的患者具有较高的基线催乳素水平 (P=0.018) 以及较大 (p=0.03) 和更具侵袭性 (p=0.002) 的肿瘤。结论：我们的患者中只有不到一半符合停用 DA 治疗的条件，在停止治疗后，不到四分之一的高催乳素血症得到缓解。这表明儿科患者泌乳素瘤的总体复发率可能高于已报道的成人。不到一半的患者符合停用 DA 治疗的条件，并且在停止治疗后，不到四分之一的高催乳素血症得到缓解。这表明儿科患者泌乳素瘤的总体复发率可能高于已报道的成人。不到一半的患者符合停用 DA 治疗的条件，并且在停止治疗后，不到四分之一的高催乳素血症得到缓解。这表明儿科患者泌乳素瘤的总体复发率可能高于已报道的成人。