伽玛刀治疗无功能型垂体腺瘤  

Treatment of nonfunctional pituitary adenoma by γ-knife

作　　者：王美华[1] 刘阿力[1] 

机构地区：[1]首都医科大学北京市神经外科研究所伽玛刀治疗中心,100050

出　　处：《中华神经外科杂志》2007年第2期131-134,共4页Chinese Journal of Neurosurgery

摘　　要：目的 评价伽玛刀治疗无功能型垂体腺瘤的适应证和疗效。方法 随访255例伽玛刀治疗后的无功能型垂体腺瘤，分成单纯伽玛刀治疗组与外科手术后加伽玛刀治疗组，平均随访时间34．2个月（6—90个月）。单纯伽玛刀治疗组187例，平均周边剂量14．6Gy；手术加伽玛刀治疗组68例，平均周边剂量13．5Gy。结果 单纯伽玛刀治疗的187例无功能型垂体腺瘤中，肿瘤缩小127例（67．9％），肿瘤大小无变化的56例（29．9％），肿瘤增大4例（1．2％）。术后肿瘤残留或复发加伽玛刀治疗的68例无功能型垂体腺瘤中，肿瘤缩小45例（66．2％），肿瘤大小无变化21例（30．9％），肿瘤增大2例（2．9％）。本组随访255例肿瘤总控制率97．6％，出现新的垂体功能低下7例。结论 伽玛刀治疗无功能型垂体腺瘤是有效和安全的，特别是开颅术后肿瘤残留和复发的病人，并发症少，优于常规放疗。Objective To evaluate the indication and efficiency of nonfunctioning pituitary adenoma managed by γ-knife. Methods Totally 255 cases of γ-knife managed nonfunctioning pituitary adenoma patients were followed up by a mean time of 34.2 months （ from 6 months to 90 months）. The patients were devided into groups according to the manage modality, γ-knife alone group and γ-knife in combination with neurosurgery group. The mean tumor margin dose was 14.6Gy and 13.5Gy respectively for the 187 cases managed by γ-knife alone and 68 cases managed by γ-knife in combination with neurosurgery. Results 127 patients （67.9%） showed tumor volume descrease and 56 patients （29.9%） showed no tumor volume change in the 187 cases of γ-knife alone managed group. 4 patients （ 1. 2% ） showed tumor volume increase. 45 patients （66.2%） showed tumor volume decrease and 21 patients （30.9%） showed no tumor volume change and 2 patients （ 2.9% ） showed tumor volume increase in the 68 cases of patients first treated by craniotomy and then by γ-knife because of tumor residue or recurrence. The overall tumor control rate were 97.6% with 7 cases of new developed hypopituitarism patients. Conclusions γ-knife is an efficient and safe modality for nonfunctioning pituitary adenomas with few complications, especially for patients with tumor residue or recurrence after craniotomy.

关 键 词：伽玛刀 垂体腺瘤 无功能型 

分 类 号：R686[医药卫生—骨科学]