立体定向放射治疗脑垂体瘤344例远期疗效观察  

Long-term outcome follow-up study of stereotactic radiosurgery treatment for 344 cases of cerebral pituitary adenoma

作　　者：李素敏[1] 赵庆秋[1] 杜亚丽[1] 

机构地区：[1]河北省人民医院医学影像中心,河北石家庄050051

出　　处：《临床荟萃》2007年第12期846-848,共3页Clinical Focus

摘　　要：目的评价立体定向放射治疗脑垂体瘤在控制肿瘤生长和改变内分泌方面的长期疗效。方法1998年1月至2004年12月,应用伽玛刀治疗垂体腺瘤398例;344例获得随访,随访期18~72个月,平均46个月;针对不同组织类型肿瘤采用相应治疗剂量,应用45%~55%等剂量曲线覆盖肿瘤至少95%以上;无功能腺瘤边缘治疗剂量10~18 Gy（平均14.6 Gy）,中心剂量20~36 Gy（平均28.8 Gy）;功能性腺瘤边缘治疗剂量12~35 Gy（平均22.7 Gy）,中心剂量24~70 Gy（平均52.9 Gy）。结果肿瘤控制生长率达91.6%,症状改善率达85.2%,激素水平下降或恢复正常达86.0%,无死亡,无严重并发症。结论立体定向放射治疗脑垂体瘤无论是对治疗首选还是对术后残存的肿瘤,其控制生长和改善内分泌的作用均是安全和有效的,治疗后影像学改变和内分泌变化与治疗剂量密切相关。Objective To evaluate the long-term outcome in the tumor growth and endcrinological response after stereotactic radiosurgery treatment for pituitary adenoma. Methods From January 1998 to December 2004, 398 patients with pituitary adenoma were treated with gamma knife. Among them,344 cases were involved in the follow-up survey. The mean period was 46 months （18-72 months）. According to the histological type, different dosage was used. At least 95% of the turmor were covered in the 45 %- 55% dose line. To nonfunctional adenoma,the prescription marginal dose was 10- 18 Gy（mean 14.6 Gy）, center dose 20 - 36 Gy（mean 28.2 Gy） ; to functional adenoma the marginal dose was 12-35 Gy（mean 22.7 Gy）,center dose 24-70 Gy（mean 52. 9 Gy）. Results Control of tumor growth was achieved in 91.6% of all, symptom improvement was seen in 85.2% and a significant decrease or normalization of excessive hormone product was seen in 86.0% of all the patients. There were no death and severe complications. Conclusion The stereotactic radiosurgery as a primate treatment for pituitary adenoma or one method for residual tumor was safe and effective in control of turmor growth and endocrinological response. The endocrinological and imaging changes after stereotactic radiosurgery treatment were correlated to the therapy dosage.

关 键 词：垂体腺瘤 Γ射线 治疗结果 

分 类 号：R739.41[医药卫生—肿瘤]