伽玛刀治疗功能性垂体瘤初步报告  

Preliminary reporting of Gamma knife treatment of hormone-producing pituitary adenomas

作　　者：陈群[1] 陈去病[1] 李仲冕[1] 姜红[1] 杜志强[1] 

机构地区：[1]镇江市第一人民医院伽玛刀治疗中心,212002

出　　处：《立体定向和功能性神经外科杂志》2004年第4期214-217,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的　对伽玛刀治疗分泌型垂体瘤的疗效和并发症发生的相关因素进行探讨。方法　 1997年 9月至 2 0 0 1年 11月 ,2 4 8例垂体瘤经伽玛刀治疗。其中 ,73例年龄在 16至 6 1岁的分泌型垂体瘤获得详细随访 ,5 3例为PRL型 ,11例GH型 ,2例为ACTH型 ,6例为PRL合并GH型 ,1例为PRL合并ACTH型。 7例为术后复发和残留。 2 3例曾接受过嗅隐亭治疗。平均肿瘤容积为 5 .83cm3 (0 .14～ 2 5 .2 0cm3 )。边缘剂量为 8～ 35Gy。 结果　平均随访时间 2 1个月。 36例 (4 9.3% )内分泌恢复正常。内分泌恢复正常的比率 3个月后 1.4 % ,6个月后 16 .4 % ,1年后 4 5 .2 % ,2年后 4 9.3%。 3例 (4 .1% )发生垂体瘤功能低下。 1例复发二次治疗。无病例发生视路受损。结论　伽玛刀治疗分泌型垂体瘤是安全有效的治疗方法。其长期疗效和并发症的发生仍需进一步的随访观察。Objective The purpose of this retrospective study is to evaluate the efficacy and the factors associated with the incidence of complications.Methods Between Sep.1997 and Nov.2001,248 patients with pituitary adenomas underwent Gamma Knife.73 patients aged 16 to 61 years with hormone-producing pituitary adenomas were followed in detail:53 patients with prolactin(PRL)-producing tumors,11 patients with growth hormone(GH)-producing tumors,2 patients with adrenocorticotrophic (ACTH)-producing tumors,6 patients with tumors that secreted both PRL and GH,1 patients with a tumor that secreted both PRL and ACTH.7 patients with residual and recurrent pituitary adenomas.23 patients who received hormone-suppressive medications.The mean tumor volume was 5.83cm 3(range 0.14～25.20cm 3).The mean prescription marginal dose was 8 to 35Gy.Results The mean following-up times was 21 months.In 36 patients(49.3%) there was normalization of hormone secretion after Gamma Knife.The rates of endocrine normalization were 1.4% after 3 months,16.4% after 6 months,45.2% after 1year and 49.3% after 2 years.In 3 patients (4.1%) there was pituitary insufficiency.1 patient was recurring.The patients' vision and visual fields were unaffected.Conclusion Gamma Knife is a safe and effect method in the treatment of patients with hormone-producing pituitary adenomas.The effect and complications require more analysis in further studies.

关 键 词：伽玛刀 分泌型垂体瘤 

分 类 号：R739.41[医药卫生—肿瘤]