无功能垂体腺瘤的伽玛刀治疗  

Treatment of nonfunctioning pituitary adenomas by gamma knife

作　　者：张铭 曹恺 林益光[3] 刘晓民[4] Zhang Ming;Cao Kai;Lin Yiguang;Liu Xiaomin(Graduate School,Tianjin Medical University,Tianjin 300070,China;Department of Neurosurgery,Tianjin Occupational Diseases Prevention and Control Hospital,Tianjin 300011,China;Gamma Knife Center,Department of Neurosurgery,Second Hospital of Tianjin Medical University,Tianjin 300211,China;Gamma Knife Center,Department of Neurosurgery,Tianjin Huanhu Hospital,Tianjin 300350,China)

机构地区：[1]天津医科大学研究生院,300070 [2]天津市职业病防治院神经外科,300011 [3]天津医科大学第二医院神经外科伽玛刀中心,300211 [4]天津市环湖医院神经外科伽玛刀中心,300350

出　　处：《中国微侵袭神经外科杂志》2018年第7期301-304,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的评价伽玛刀治疗无功能垂体腺瘤(nonfunctional pituitary adenomas,NFA)的可行性和安全性。方法回顾性分析首选伽玛刀治疗的73例NFA病人的临床资料。对影响肿瘤控制和术后并发症的因素进行卡方检验及Logistic回归分析。结果肿瘤总控制率为93.2%。5年无进展生存率为92.6%,10年无进展生存率为88.2%。肿瘤体积<5 cm^3者的肿瘤控制率为96.5%,体积≥5 cm^3者肿瘤控制率为81.3%,组间差异有统计学意义(P=0.033)。随访12~178个月,新发垂体功能低下5例,Logistic单因素和多因素分析显示边缘剂量是主要影响因素(P=0.01,P<0.01)。结论对于不适宜首选手术或拒绝手术的小体积NFA病人,伽玛刀显现出较高的肿瘤控制率和较低的并发症发生率。Objective To evaluate the feasibility and safety of gamma knife treatment for nonfunctional pituitary adenomas（NFA）.Methods Clinical data of 73 patients with NFA treated with gamma knife as first choice were analyzed retrospectively. The factors affecting tumor control and postoperative complications were tested by chi-square test and Logistic regression analysis. Results The total tumor control rate was 93.2%. The 5-year progression-free survival rate was 92.6% and the 10-year progression-free survival rate was 88.2%. When the tumor volume was less than 5 cm^3, the tumor control rate was 96.5%, and the tumor control rate was 81.3% in a volume equal to and greater than 5 cm^3, and the difference was statistically significant between the 2 groups（P = 0.033）. The patients were followed up from 12 to 178 months, new hypopituitarism occurred in 5 patients. Logistic univariate and multivariate analyses showed that marginal dose was the main factor influencing hypopituitarism（P = 0.01, P〈0.01）. Conclusion For NFP patients with small volume, who reject surgery or surgery is not suitable for the first choice, gamma knife shows a higher rate of tumor control and a lower rate of complications.

关 键 词：垂体肿瘤 无功能 伽玛刀 垂体功能减退症 控制率 

分 类 号：R739.41[医药卫生—肿瘤]