伽玛刀对垂体瘤肿瘤控制的效果分析

Control of Tumor with Gamma Knife in Patients with Pituitary Adenomas

目的评价伽玛刀治疗对垂体腺瘤肿瘤控制的疗效及相关并发症。方法回顾性分析2004年7月至2008年11月间,在四川大学华西医院接受伽玛刀治疗的191例垂体腺瘤患者的临床资料。伽玛刀治疗周边剂量11～33Gy,平均周边剂量26.3Gy,以45%～75%等剂量曲线覆盖病灶。术后定期复查鞍区MRI和血液激素水平,对复查结果进行对比分析。结果随访病例肿瘤控制有效率为95.2%,其中非功能性垂体腺瘤肿瘤控制有效率为100%,肿瘤体积明显缩小发生时间平均在伽玛刀治疗后11.4个月,功能性垂体腺瘤肿瘤控制有效率平均为93.8%,肿瘤体积明显缩小发生时间平均在伽玛刀治疗后18.6个月。伽玛刀治疗后新发垂体功能低下发生率为11.5%,伽玛刀治疗后无患者加重视力视野障碍。结论伽玛刀能有效地控制肿瘤生长,是安全有效的垂体腺瘤治疗手段。

Objective To evaluate the effectiveness and complications of gamma knife surgery for treating pituitary adenomas. Methods Retrospective analyses of 217 cases of pituitary adenomas （from July 2004 to November 2008） were performed in Sichuan university＇s West China Hospital. The patients were treated with an average dose of 26.3 Gy （range 11-33 Gy） and 45%-75% isodose line. Data from serial saddle area MRI and blood endocrine hormone tests were examined. Resnlts Of the 191 patients being followed up, 95.2% had their tumors effectively controlled. All non-functional pituitary adenoma were controlled, with the size of tumor shrinking significantly in an average of 11.4 months after gamma knife surgery. About functional pituitary adenoma were controlled, with the size of tumor shrinking significantly in an average of 18. 6 months. Pituitary hypofunction occurred in 11.5% of patients after the surgery. No patient experienced exacerbation of poor eyesight and visual field after gamma knife surgery. Conclusion Gamma knife can effectively control tumor growth and is a safe and effective treatment for pituitary adenoma.