伽玛刀治疗功能性泌乳素腺瘤患者内分泌改变及疗效分析  

Effect of Gamma knife on endocrine changes in patients with functional pituitary prolactinomas

作　　者：苗丽[1] 徐如祥[1,2] 

机构地区：[1]南方医科大学珠江医院神经外科,南方医科大学广东神经外科研究所,广东省脑功能修复与再生重点实验室,广州510282 [2]北京军区总医院神经外科,北京100700

出　　处：《中华神经医学杂志》2010年第1期54-56,共3页Chinese Journal of Neuromedicine

摘　　要：目的评价伽玛刀治疗功能性泌乳素（PRL）腺瘤的疗效及患者内分泌的改善程度。方法回顾性分析135例应用伽玛刀治疗的功能性PRL腺瘤患者的临床资料，按照治疗剂量分为3组，A组：中心剂量50～60Gv（含50Gy），边缘剂量：20～30Gy；B组：中心剂量40～50Gy，边缘剂量15～25Gy；C组：中心剂量30～40Gy，边缘剂量12～20Gy；比较3组患者的临床资料和伽玛刀治疗后PRL水平的改变。结果伽玛刀治疗后患者临床症状部分缓解90例（66．7％1，全部缓解35例（25．9％），无变化10例（7．4％）；3组患者的年龄、性别及肿瘤大小差异均无统计学意义（P〈0．05），经不同剂量伽玛刀治疗后患者PRL正常率不同，差异有统计学意义（F=8．604，P=0．000），两两比较结果显示伽玛刀中心剂量和边缘剂量较高时．PRL正常率较高。结论伽玛刀治疗功能性PRL腺瘤，在控制肿瘤的同时改善内分泌功能，可以作为临床治疗功能性PRL腺瘤的方法之一。Objective To investigate the clinical efficacy of Gamma knife treatment on patients with functional pituitary prolacfinoma （PRL） and its endocrine response. Method We retrospectively analyzed the clinical data of 135 cases of functional pituitary prolactinoma treated with Gamma knife in our hospital from Oct 1994 to Jan 2008. All patients were divided into 3 groups： group A （a central dose of 50 to 60 Gy, a marginal dose of 20 to 30 Gy）; group B （a central dose of 40 to 50 Gy, a marginal dose of 15 to 25 Gy） and group C （a central dose of 30 to 40 Gy, a marginal dose of 12 to 20 Gy）. The dose in the optic nerves of the 3 groups was under 9 Gy. Results After treated with Gamma knife, partial remission （PR） of the clinical symptoms appeared in 90 patients （66.7%）; complete remission （CR） of those was showed in 35 （25.9%） and no change of those appeared in 10 （7.4%）. No significant difference was found between age and both sex and tumor sizes in the 3 group （P〈0.05）. Different normal PRL rates was concluded by using different doses of Gamma knife （F=8.604, P=0,000）. Pairwise comparison indicated that high dose of Gamma knife resulted in high PRL normal rates with statistical significance （P〈0.05）. Conclusion Gamma knife treatment used in patients with functional pituitary adenoma can not only control the growth of tumor, but also improve the dysfunction of endocrine, which should be adopted as the first choice for clinical treatment of functional pituitary prolactinoma.

关 键 词：泌乳素腺瘤 伽玛刀 内分泌功能 

分 类 号：R739.41[医药卫生—肿瘤]