放射治疗垂体瘤96例分析

RADIOTHERAPY OF PITUITARY ADENOMA——analysis of 96 patients

1970年7月至1987年7月本科共收治垂体瘤放射治疗129例。本文总结分析其中资料完整可供分析96例,以首次治疗方式分为单纯放疗组(简称单放组)41例,经额入路手术术后放疗组(简称额+放组)35例,1986年2月开始采用经鼻蝶入路手术,术后放疗20例(简称鼻+放组)。现将治疗结果和放疗的作用及剂量等问题作一分析和讨论。

From 1970 to 1978, 96 patients with pituitary adenoma were treated by radiotherapy, 41 patients received radiotherapy alone (R group), 35 received surgery followed by radiation (S + R group) and 20 received transnasal resection plus radiation (T + R group). According to Fordaucauder's staging system, 35(36.5%) patients had Stage Ⅱ, 44 (45.8%) had stage Ⅲ, 15 (15.6%) Stage Ⅳ and 2 (2.1%) Stage V lesions. The 5- and 10- survival rates of the R group were 87% and 66.7%. Those of the S+R group were 93.8% and 75%, respectively (P>0.1). The 3-year survival rate of T + R group was 85% (P> 0.1). The recurrence rales after 45Gy and 45-50 Gy were 49% (24/49) and 12.7% (P<0.01). Re-radiation after recurrence still gave satisfactory results though Stage Ⅱ and Ⅲ lesions gave different results from Stage IV lesions(P<0.01). The optimum dose and action on pituitary adenoma are discussed.