难治性垂体瘤的治疗现状  

Current status of treatment of refractory pituitary tumors

作　　者：孔繁一 湛清扬 王宁[1] KONG Fanyi;ZHAN Qingyang;WANG Ning(The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Institute of Traditional Chinese Medicine,Heilongjiang University of Chinese Medicine,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第一医院,黑龙江哈尔滨150001 [2]黑龙江中医药大学中医药研究院,黑龙江哈尔滨150000

出　　处：《中国实用神经疾病杂志》2022年第9期1163-1167,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：大多数垂体腺瘤(PAS)被认为是良性肿瘤,但约有0.2%可出现转移,并被归类为垂体癌(PC)。难治性垂体腺瘤位于良性腺瘤和真正的恶性PC之间,其特点是Ki-67指数高,生长迅速,复发频繁,对包括替莫唑胺在内的常规治疗耐药。由于有限的治疗选择,难治性PAS和PC的治疗非常困难。现有初始治疗手段通常以多次手术及放射技术为基础治疗方案,标准的药物治疗仅能控制其激素水平,不能控制其肿瘤生长及复发,替莫唑胺作为唯一正式被推荐的治疗方法,仅对35%左右的患者有效。随着对难治性垂体瘤遗传学及微环境领域的研究取得进展,各种针对个体化的新兴治疗方法不断出现,包括多肽受体放射性核素治疗、血管生成靶向治疗和免疫治疗,有望改善患有这种严重疾病的患者的预后。Most pituitary adenomas(PAS)are considered benign,but about 0.2%can metastasize and are classified as pituitary carcinomas(PC).Refractory pituitary adenomas lie between benign adenomas and true malignant PCs and are characterized by a high Ki-67 index,rapid growth,frequent recurrence,and resistance to conventional treatments including temozolomide.Treatment of refractory PAS and PC is very difficult due to limit⁃ed treatment options.Existing initial treatment methods are usually based on multiple surgeries and radiation tech⁃niques.Standard drug therapy can only control their hormone levels,but cannot control their tumor growth and re⁃currence.%of patients are effective.With advances in research on the genetics and microenvironment of refracto⁃ry pituitary tumors,various emerging therapeutic approaches for individualization,including peptide receptor ra⁃dionuclide therapy,angiogenesis-targeted therapy,and immunotherapy,are expected to emerge.Improve out⁃comes for patients with this serious disease.

关 键 词：难治性垂体腺瘤 替莫唑胺 放射技术 免疫治疗 mTOR通路治疗 

分 类 号：R739.41[医药卫生—肿瘤]