伽玛刀治疗垂体腺瘤

Treatment of Pituitary Adenoma with Gamma-knife

目的评价研究伽玛刀治疗垂体腺瘤的效果，探讨影响其疗效的因素。方法总结67例垂体腺瘤的伽玛刀治疗与随访资料。其中PRL腺瘤37例，GH腺瘤10例，ACTH腺瘤2例，混合性腺瘤3例，无功能性腺瘤15例；肿瘤直径为6．2～39．0mm。采用1．5T磁共振定位，Gamma-Plan计划系统规划，等剂量曲线45％～60％，治疗实施周边剂量为9～35Gy，中心剂量为20～70Gy。结果随访3～26个月，肿瘤控制66例（98．5％），肿瘤缩小41例（61．2％），肿瘤完全消失2例（3．0％），内分泌症状改善47例（88．0％）。结论伽玛刀对于垂体腺瘤是一种安全有效的治疗方法，其疗效与腺体的类型、体积、照射剂量和MR／信号特征密切相关。

Objective To evaluate the efficacy of Gamma-knife on pituitary adenoma, and study the treatment methodology and effecting. Methods The data of 67 patients with pituitary adenomas who were treated with Gamma-knife and followed up for 3 to 26 months, were analyzed. This included 37 cases of prolactinomas, 10 cases of growth hormone secreting adenomas, 2 cases of adrenocorticotrophic hormone corticotropin adenomas, 3 cases of mixed-functional adenomas, and 15 cases of naught functional pituitary adenoma. The tumor diameter was 6.2-39.0 mm . The 1.5 Tesla MRI and Gamma-Plan system were used to orientate the tumor. The margin dose was 9-35 Gy at the 45%-60% isodose tine. The center dose was 20-70 Gy. Results The followed-up period was 3 to 26 months. The tomors were comptetly disappeared in 2 cases （3.0%） and sharnd in 41 cases（61.2%）. No changed existed in 23 cases （34.3%）. The local tumor control was 98. 5% . The rate of hormone improvenment was 47 cases（88. 0%）. Conclusion The Gamma-knife is an effective treatmeat method for those pituitary adenoma which do not fit operation. The theraptutic effects are related to the pituitary adenoma of type, Volume, radiation treated dose, radiation treated volame , MRI signal and so on.