伽玛刀治疗垂体微腺瘤远期对垂体功能的影响

The Long-term Effect of Gamma Knife on Pituitary Function of Patients with Pituitary Microadenoma

背景与目的:立体定向伽玛刀治疗垂体瘤在临床已经广泛开展,但治疗垂体微腺瘤的报道仍较少,而且伽玛刀治疗远期对垂体功能的影响至今尚不明确,尤其引起垂体功能损害的情况仍令人担忧。回顺性分析伽玛刀治疗垂体微腺瘤的远期对垂体功能的影响,尤其是引起垂体功能低下的情况。方法:随访应用 Leksell伽玛刀治疗的垂体微腺瘤患者,获得完整资料109例,进行回顺性分析。所有随访时间超过5年,平均 89.40个月。结果:33例在术前存在不同程度垂体功能低下,治疗后28例恢复正常(84.8%);本组有8例目前存在垂体激素水平低下,但只有1例与本次治疗有明确关系,5名目前无自诉症状,有症状而且需要激素替代治疗有3例(2.7%)。结论:伽玛刀治疗垂体微腺瘤远期引起垂体功能低下的发生率极低,而对改善垂体功能低下有明确的效果。

BACKGROUND ＆ OBJECTIVE： Gamma knife treatment affect pituitary function is one of the important aspects. This study was to analyze the long-term effect on pituitary function by the stereotactic gamma knife treatment for pituitary microadenomas retrospectively, especially. METHODS： One hundred and nine patients with pituitary microadenomas treated by Leksel gamma knife in our unit from August of 1995 to December of 1998 were analyzed. The follow-up period of all cases was more than 5 years, with an average of 89.40 months. RESULTS： Thirty-three cases suffered from hypopituitarism before treatment, of whom 28 （84.8%） cases recovered after gamma knife radiosurgery. There were 8 cases with serum hypophyseal hormone lower than normal level, among whom, however, hypopituitarism of only 1 patient was related to the gamma knife treatment and 5 showed no manifestations of hypopituitarism. The other 3 cases manifested with symptoms and were treated with hormone replacement therapy, accounting for 2.7% of all cases. CONCLUSIONS： Gamma knife treatment for pituitary microadenoma seldom lead to hypopituitarism for long-term. On the contrary, it could improve the hypopituitarism for most of the cases.