伽玛刀治疗垂体微腺瘤的远期分析  

The analysis of long-term effect on stereotactic gamma knife treatment for pituitary microadenoma

作　　者：徐波涛[1] 梁军潮[1] 吴鸿勋[1] 覃子衡[1] 王玉宝[1] 王国良[1] 宁琼芳[1] 王伟民[1] 王任直(点评)[2] 

机构地区：[1]广州军区广州总医院神经外科,510010 [2]北京协和医院神经外科

出　　处：《中华神经外科杂志》2008年第5期327-330,共4页Chinese Journal of Neurosurgery

摘　　要：目的分析伽玛刀治疗垂体微腺瘤的远期疗效。方法回顾性分析Leksell伽玛刀治疗的109例垂体微腺瘤。结果影像学肿瘤消失、缩小、无变化和增大分别为45例、37例、22例和5例；血液激素完全恢复39例，部分恢复23例，无明显变化15例，继续增高14例。33例垂体功能低下的患者，治疗后28例恢复正常；8例目前存在垂体激素水平低下，但只有1例与本次治疗有明确关系，5例无自诉症状，需要激素替代治疗有3例。症状完全消失或明显改善62．6％，稍改善或无变化31．3％，继续恶化6．1％。结论伽玛刀治疗效果肯定，创伤小，治疗风险低，可以作为治疗垂体微腺瘤的主要方法之一。Objective To evaluate long-term efficacy of gamma knife on the treatment of pituitary microadenoma. Method We followed up all the patients of pituitary microadenoma performed with Leksell gamma knife in our unit during 1995.8-1998.12, in whom 109 cases were obtained which information fitting our demand. Results In the imaging follow-up, the number of vanishing, diminution, unchanging and augmentation of tumor volume was in 45,57,22 and 5 cases respectively. In the endocrine follow-up, the number of complete recovery of hormone was in 59 cases, partly recovery in 25 cases, no marked change in 15 cases, and keeping on rising in 14 cases. In our group, 55 cases suffered from hypopituitarism before gamma knife, among which 28 cases recovered normally after radiosurgery, achieving effective percentage of 84.8%. There were 8 cases showing some hypophyseal hormone lower than normal level in the present blood examination, among them, however, only one was perhaps related to the gamma knife treatment, and 5 cases had no complaints, and the other 5 displayed symptom and needed hormone replacement therapy, occupying percentage of 2.7%. Patients whose complaints disappeared completely or obviously accounted for 62.6%, showed slight or no improvement for 31. 3% , and aggravated for 6. 1%. Conclusions Gamma knife treatment for pituitary microadenoma showes affirmative efficacy, brings little trauma, has lower risk and less complication. It could be one choice of surgical therapeutic method for pituitary microadenoma.

关 键 词：立体定位技术 放射外科手术 垂体肿瘤 伽玛刀 远期疗效 

分 类 号：R736.4[医药卫生—肿瘤]