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

Journal Article · · Ann. Intern. Med.; (United States)
; ; ; ; ;

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), Journal Name: Ann. Intern. Med.; (United States) Vol. 92:5; ISSN AIMEA
Country of Publication:
United States
Language:
English

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Related Subjects

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