围立体定向放射治疗期使用生长抑素类似物对生长激素腺瘤患者放疗疗效的影响研究进展  

Effect of somatostatin analogues on endocrine remission after stereotactic radiosurgery in somatotropinomas

作　　者：Vladimir Melnikov 俞一飞 何敏 张朝云 李益明 Melnikov Vladimir;Yu Yifei;He Min;Zhang Zhaoyun;Li Yiming(Department of Endocrinology,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院内分泌科,上海200040

出　　处：《国际内分泌代谢杂志》2024年第4期250-254,共5页International Journal of Endocrinology and Metabolism

摘　　要：术后放射治疗可使60%~70%的肢端肥大症患者达到生化缓解,但起效缓慢,从治疗起效到生化缓解需要27.5~43.0个月的时间。立体定向放射治疗是目前常用的放疗类型,该疗法采用精准且高剂量的电离辐射照射生长激素腺瘤,相比普通放疗,可以使患者更快地达到生化缓解。由于放疗的起效时间比较长,为更好的控制生化水平,有临床指南推荐接受放疗的患者在放疗前接受生长抑素类似物治疗,并在放疗后使用生长抑素类似物作为过渡治疗。但目前对于围放疗期使用生长抑素类似物对肢端肥大症患者的生化缓解是否有影响存在争议,需要进一步探索,并确认围放疗期是否需要使用生长抑素类似物治疗以及使用的时间窗。Stereotactic radiosurgery,secondary to pituitary adenoma resection,is able to achieve 60%-70%biochemical remission rates in patients with acromegaly.The treatment effect of radiosurgery is slow,requiring approximately 27.5-43.0 months from treatment to endocrine remission.Stereotactic radiosurgery,a commonly used type of radiation therapy in growth hormone-secreting pituitary adenomas,or somatotropinomas,directs precise and high-dose ionizing radiation onto the tumors.Compared to traditional radiotherapy,stereotactic radiosurgery is able to achieve endocrine remission in a shorter time span.Clinical guidelines recommend that patients receiving radiation therapy often need to undergo pharmacological treatment with somatostatin analogues before radiotherapy,and use somatostatin analogues as transitional therapy after radiotherapy to further reduce the time to remission.Somatostatin analogues are the most commonly used type of drugs in acromegaly treatment.However,further exploration and research are needed to determine whether the use of somatostatin analogues during the peri-radiosurgery period has an impact on the biochemical response of patients with acromegaly,and whether it is necessary to discontinue somatostatin analogues during this period of time.

关 键 词：肢端肥大症 生长激素腺瘤 生长抑素类似物 立体定向放射治疗 

分 类 号：R584.11[医药卫生—内分泌]