Sustained remission of Cushing's disease with mitotane and pituitary irradiation

Journal Article · Thu May 01 00:00:00 EDT 1980 · Ann. Intern. Med.; (United States)

DOI:https://doi.org/10.7326/0003-4819-92-5-613· OSTI ID:5176633

Schteingart, D E; Tsao, H S; Taylor, C I; McKenzie, A; Victoria, R; Therrien, B A

Low doses of mitotane were given orally to 36 patients with Cushing's disease, concurrently with or after pituitary cobalt irradiation. Clinical and biochemical remission occurred in 29. The response to treatment occurred early in 17 patients and late in 12. The different pattern of response to mitotane was not related to the dose given or to its serum level. Early biochemical indicators of adrenal suppression with mitotane were a sharp decrease in adrenal response to the infusion of ACTH and in plasma levels of dehydroepiandrosterone sulfate. Although mitotane was given together with pituitary irradiation, initial remission was due mainly to the adrenal effect of mitotane. Plasma ACTH levels were still elevated when cortisol had returned to normal. In seventeen of the 29 patients who responded to treatment drug therapy has been discontinued, and they remain in remission of Cushing's syndrome. Side-effects have been dose dependent, with anorexia, nausea, decreased memory, and gynecomastia in men being the commonest.

• Research Organization: Univ. of Michigan, Ann Arbor
• OSTI ID: 5176633
• Journal Information: Ann. Intern. Med.; (United States), Vol. 92:5
• Country of Publication: United States
• Language: English

Related Subjects

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
SIDE EFFECTS
CUSHING SYNDROME
RADIOTHERAPY
BIOLOGICAL RADIATION EFFECTS
ACTH
ANOREXIA
ANTINEOPLASTIC DRUGS
BIOCHEMISTRY
COBALT 60
DOSE-RESPONSE RELATIONSHIPS
EXTERNAL IRRADIATION
FRACTIONATED IRRADIATION
GAMMA RADIATION
LOCAL IRRADIATION
MAMMARY GLANDS
NAUSEA
PATIENTS
PITUITARY GLAND
RADIOSENSITIVITY EFFECTS
RESPONSE MODIFYING FACTORS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL EFFECTS
BODY
CHEMISTRY
COBALT ISOTOPES
DISEASES
DRUGS
ELECTROMAGNETIC RADIATION
ENDOCRINE DISEASES
ENDOCRINE GLANDS
GLANDS
HORMONES
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
IONIZING RADIATIONS
IRRADIATION
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
MINUTES LIVING RADIOISOTOPES
NUCLEAR MEDICINE
NUCLEI
ODD-ODD NUCLEI
ORGANS
PEPTIDE HORMONES
PITUITARY HORMONES
RADIATION EFFECTS
RADIATIONS
RADIOISOTOPES
RADIOLOGY
SYMPTOMS
THERAPY
YEARS LIVING RADIOISOTOPES
560151* - Radiation Effects on Animals- Man
550603 - Medicine- External Radiation in Therapy- (1980-)
550600 - Medicine