生长激素型垂体腺瘤伽玛刀治疗的疗效分析  

Knife Radiosurgery for growth hormone-secreting pituitary adenoma:Therapeutic effect analyse

作　　者：林伟标[1] 赵洪洋[1] 张方成[1] 朱贤立[1] 黄俊红[1] 付鹏[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院神经外科,武汉430022

出　　处：《立体定向和功能性神经外科杂志》2009年第2期94-97,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的评价leksell伽玛(γ)刀治疗生长激素型垂体腺瘤的疗效。方法对我院自2005年1月至2008年3月应用伽玛刀治疗41例生长激素型垂体腺瘤患者进行回顾性分析,肿瘤直径4～38.6mm,平均15.2mm。采用1.5T磁共振定位,Gamma-Plan计划系统规划,等剂量曲线16%～60%,治疗周边剂量9.95～35 Gy,中心剂量31.25～70 Gy。结果33例获随访,30例(90.9%)患者临床症状改善,16例(48.4%)患者的血清生长激素(GH)值降到正常水平,12例(36.3%)患者GH值下降,4例(12.1%)患者GH值无变化。24例(72.7%)患者肿瘤缩小,9例(27.2%)患者肿瘤无改变。结论γ刀治疗在控制生长激素型垂体腺瘤生长和改善内分泌症状是安全有效的,是GH微腺瘤首选治疗方法;对肿瘤术后残存或复发,尤其是侵袭海绵窦的患者,γ刀是最好的补充治疗。Objective To evaluate the efficacy of gamma knife radiosur--gery（GKS） in treatment of growth hormone（GH）-secreting pituitary adenoma. Methods The clinical outcomes were described for 33 consecutive case of GH treated with GKS. Their therapeutic effect and the related factors were analysed. Adenoma diameter varied from 4 to 38. 6mm, averaging 16. 2mm. The 1. 5Tesla MRI and Gamma--Plan system were used to orientate the adenomas. The margin dose was 9. 95-35 Gy at the 16%-60% isodose curve. The center dose was 31.25-70Gy. Results 33 cases were followed up. Clinical symptoms im--proved in 30 cases（90. 9%）.The serum GH returned normal in 16 patients （48. 4%）and declined in comparison with the level before GKS in 12 patients （36.3%）and unchanged in 12 patients（12.1%）. The tumor shrunk in 24 eases（72.7%） ,stayed in the same in 9 eases（27.2%）. Conclusion GKS is an effective and safe way to control adenoma growing and improve the endocrine symptom of the patients with GH-secreting pituitary adenoma, even can become the first choice for those with pituitary microadenoma. Gamma knife is the best supplement treatment for those patients with survival or recrudesce.

关 键 词：生长激素型垂体腺瘤 立体定向放射外科 伽玛刀 

分 类 号：R739.41[医药卫生—肿瘤]