加强临床与基础研究,提高垂体腺瘤诊治水平

Strengthen the Multidisciplinary Treatments to Improve the Clinical Outcome of Pituitary Adenoma

垂体腺瘤是一种可影响全身多系统的颅内神经内分泌肿瘤,发病率高且多为中青年,严重影响患者的生命质量。治疗目标不仅为切除肿瘤和控制异常增高的激素,还需要处理好各种并发症,如水电解质紊乱、垂体功能低下、性功能减退等,以进一步提高患者的生命质量。目前手术治疗仍为主要治疗方式,仍处于不断优化和改进中,在尽可能全切肿瘤的同时保护正常垂体组织已成为共识。随着基础和临床研究的不断深入,药物在功能性腺瘤的治疗中起到越来越重要的作用,已成为泌乳素腺瘤的首选治疗方案,规避了手术风险,这种趋势也逐步扩展到生长激素腺瘤和促肾上腺皮质激素腺瘤的治疗中。以伽玛刀为代表的立体定向放射治疗为主的辅助治疗手段,疗效也显著提高。我们应加强多学科合作,联合开展基础和临床方面研究,寻找最佳的治疗方案,提高诊疗水平、改善预后。

Pituitary adenomas are intracranial neuroendocrine tumors that could affect multiple body systems, with high incidence, especially among young and middle-aged adults, which severely deteriorate the life quality of the patients. The goal for treatment of pituitary adenoma is not limited to tumor resection and controlling exceptionally high hormone level. Moreover, several complications like water-electrolyte imbalance, hypopituitarism, abnormal sexual function should also be properly dealt with, so as to further improve the life quality of the patients. Surgery removal of the tumor, as major treatment option, has been constantly optimized and improved. It has become a consensus that normal pituitary tissue should be protected as much as possible when pursuing total tumor resection. As preclinical and clinical studies moving forward, drug therapy, avoiding surgical risks, plays a more and more important role in the treatment of functional pituitary adenomas, which made it the first-line therapy in prolactinomas and GH/ACTH adenomas as well. Stereotactic radiosurgery, represented by Gamma knife surgery, as mainstream adjuvant therapy, has also improved patient outcomes. Therefore, Multidisciplinary cooperation in the treatment of pituitary adenomas should be encouraged to improve the quality of medical care, and to achieve the most effective therapy for better prognosis of the patients.