旋转式伽玛刀治疗功能性垂体微腺瘤的远期疗效和安全性

The Long-term Therapeutic Effect and Safety of Rotatory Gamma Knife Treatment for Secretory Pituitary Microadenomas

目的探讨旋转式伽玛刀治疗功能性垂体微腺瘤的远期疗效和安全性。方法总结分析1998年3月-2006年2月经旋转式伽玛刀治疗5年以上且获得随访的功能性垂体微腺瘤患者66例,男性11例,女性55例,年龄(31.3±10.6)岁,病程(36.7±14.8)月,治疗剂量(30/9～60/30)Gy。结果临床表现缓解63例、无变化2例、加重1例,肿瘤消失或缩小59例、无变化6例、增大1例;原异常升高的垂体激素恢复正常或下降62例、无明显变化3例、升高1例,其中2例出现垂体内分泌功能低下,但只有1例有相应的临床症状且需激素替代治疗。结论旋转式伽玛刀治疗功能性垂体微腺瘤的远期效果好而且安全,引起垂体功能低下的可能性极小。

Objective To investigate the long-term therapeutic effect and safety of rotatory gamma knife treatment for secretory pituitary microadenomas.Methods The clinical and follow-up results of 66 patients of secretory pituitary microadenomas from March 1998 to February 2006,who had been treated with rotatory gamma knife for at least 5 years,were retrospectively summarized and analysed.In this series,55 patients were female and 11 were male,ranging in age from 16 to 68 years（mean 31.3±10.6 years）.The illness duration ranged from 3 months to 12 years（mean 36.7±14.8 months）.The therapeutic dose was 30/9～60/30 Gy.Result The clinical manifestations relieved in 63 cases,did not change in 2 cases and aggravated in one;the tumor disappeared or shrinked in 59 cases,remained the same size in 6 cases and enlarged in one;and the pre-treatment elevated pituitary hormone restored to normal level or decreased in 62 cases,did not show obvious change in 3 cases and increased in one.Hypopituitarism was found in only two cases,but only one presented relative clinical symptoms and needed hormone replacement therapy.Conclusion Rotatory gamma knife treatment for secretory pituitary microadenomas is secure and can exert favorable long term results,with minimum chance to cause hypopituitarism.