垂体生长激素大腺瘤常规放疗和手术加放疗后的随访观察

FOLLOW-UP RESULTS OF PITUITARY GH MACRO-ADENOMA PATIENTS TREATED BY RADIOTHERAPY OR BY SURGERY PLUS POSTOPERATIVE RADIOTHERAPY

对81例接受过常规放疗和手术加放疗的垂体生长激素(GH)大腺瘤患者进行了随访分析。结果表明:治疗后随着时间的延长,患者血清GH正常率和垂体功能低下率逐渐增加,单纯放疗和手术加放疗的疗效无明显差别,临床症状、血清GH浓度与CT阳性率有关,垂体GH大腺瘤放疗后应定期随访,作蝶鞍CT检查和血清激素放免测定。

Eighty-one patients with pituitary GH macro-adenoma treated by conventional radiotherapy alone in 64 cases and by surgery plus postoperative radiotherapy in 17 cases were reported. With follow-ups of <3 years, 3-5 years, and >5 years, the plasma GH<10 μg/L was found in 45.8% (11/24), 56.3% (9/16) and 75.6% (31/41)(P>0.05) of the patients respectively, and hypopituitarism was seen in 25%(6/24), 56.3%(9/16) and 58.5% (24/41)(P>0.05), respectively. There were no diherences between the results of the two groups of patients- The rate of positive CT imaging was found to be correlated with the clinical symptoms and the plasma GH concentration. We conclude that conventional radiotherapy alone is effective in treating pituitary GH macro-adenoma. Patients should be followed-up at regular intervals, and CT scan of the pituitary fossa and RIA of plasma hormones should be part of the follow-up.