垂体微腺瘤伽玛刀治疗后远期垂体功能的评价

The prostecdtive effect on pituitary function by stereotactic gamma knife treatment for pituitary microadenoma

目的立体定向伽玛刀治疗垂体瘤在临床已经广泛应用,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。为此,本文回顾性分析伽玛刀治疗垂体微腺瘤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,进行回顾性分析。所有病例随访时间超过5年,平均(89.40±14.43)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例目前无自诉症状,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。

Objective Stereotactic gamma knife treatment for pituitary adenoma has been performed widely in clinic. Treatment for pituitary microadenoma, however, was little reported. It is not completely clear how gamma knife affected the pituitary function for long-- term after the radiosurgery of microadenoma, and the hypopituitarism is especially paid attention. For this purpose, in the paper the prostecdtive effect on pituitary function by stereotactic gamma knife treatment for pituitary microadenoma was analyzed retrospectively, especially whether hypopituitarism could be provoked. Methods all the patients of pituitary microadenoma performed with Leksell gamma knife in our unit during 1995.8- 1998.12, were followed up in whom 109 cases were obtained of information fitting our demand. The follow-up period of all cases is more than 5 years, average （89.40±14.43） months. Results There are 33 cases suffered from hypopituitarism of some extent before gamma knife in our group, among which 28 cases recovered normally after gamma knife radiosurgery, which achieved effective percentage of 84.8 %. There are 8 cases showing some hypophyseal hormone lower than normal level in the present blood test, among whom, however, only 1 patient accepted surgical treatment first time and at the same time showed normal endocrine level before performance, and among whom 5 cases had no complaints, and the other 3 displayed symptom and needed hormone replacement therapy, occupying percentage of 2.7%, Conclusions Gamma knife treatment for pituitary microadenoma could result in hypopituitarism for long-- term in very low possibility. On the contrary, it could improve the hypopituitarism for most of the cases.