垂体腺瘤的伽玛刀治疗  

Gamma knife treatment for pituitary adenomas

作　　者：仇斌[1] 马志明[1] 刘运生[1] 侯永宏[1] 唐建兵[1] 

机构地区：[1]中南大学湘雅医院伽玛刀治疗中心,长沙410008

出　　处：《中南大学学报（医学版）》2004年第4期463-466,共4页Journal of Central South University ：Medical Science

摘　　要：目的 :评价垂体腺瘤的伽玛刀治疗在控制肿瘤生长和改善内分泌异常方面的作用和疗效。方法 :对2 2 8例垂体腺瘤患者采用 1 .0TMRI和Gamma Plan计划系统联网定位 ,Leksell B型伽玛刀实施放射外科治疗 ,治疗周边剂量 1 2～ 35Gy ,平均 2 1 .3Gy(NFA :1 5 .9Gy ;FA :2 7.6Gy) ,中心剂量 2 4～ 70Gy ,平均 4 6 .6Gy(NFA :31 .8Gy ;FA :5 0 .3Gy)。结果 :1 1 6例随访 4～ 6 7个月 ,平均 2 7.4个月 ,1 1 3例 (97.4 % )肿瘤生长得到控制。 98例 (84 .5 % )肿瘤体积缩小 5 0 %以上 ,肿瘤体积增大 3例 (2 .6 % )。分泌功能腺瘤伽玛刀治疗后内分泌症状改善率 89.8% ,激素水平正常化为 4 9.7%。并发症 6 %。结论 :伽玛刀治疗垂体腺瘤 ,具有创伤小、安全、并发症少的优点 。Objective To evaluate the function and effect of Gamma knife radiosurgery(GKR) in controlling the tumor growth and improving endocrinological abnormality of pituitary adenomas. Methods Two hundred and twenty eight cases of pituitary adenoma were treated with Leksell Gamma knife. 1.0Tesla MRI and Gamma Plan system were used to orientate the tumor. The margin dose was 12～35 Gy, mean 21.3 Gy; the center does was 24～70 Gy, mean 46.6Gy (NFA,31.8 Gy;FA,50.3 Gy). Results One hundred and sixteen cases (NFA,28;FA,88) were followed up for 4～67 months,and the mean was 27.4 months. The growth of tumors in 113 cases(97.4% ) was controlled. The tumor volume became smaller in 98 cases (84.5%). Three cases (2.6%) grew larger in tumor size. A significant decrease of excessive hormone production was seen in 89.8% of the patients, and the endocrinological normalization rate was 49.7% (PRL, 47.2%; GH,57.1%; ACTH,55.6%). Postradiosurgical complications were seen in 6%.Conclusion Gamma knife radiosurgery is safe and effective in controlling the tumor growth and improving endocrinological abnormality of pituitary adenoma.

关 键 词：伽玛刀治疗 垂体腺瘤 并发症 肿瘤生长 内分泌异常 肿瘤体积 疗效 激素水平 分泌功能 

分 类 号：R736.4[医药卫生—肿瘤]