伽玛刀放射外科治疗垂体腺瘤的疗效评价

Evaluation on gamma knife radiosurgery in treatment of pituitary adenomas

目的评价伽玛刀(Gamma Knife)放射外科治疗垂体腺瘤的疗效及安全性。方法对2010年1月~2013年12月期间采用OUR旋转式伽玛刀作为首选方法治疗的143例垂体腺瘤患者的临床资料进行回顾性研究,PRL型54例、GH型24例、ACTH型11例、混合型(GH+PPL)15例和无功能型(NFA)39例。肿瘤直径2 mm^64 mm(平均26.3 mm),30%~70%等剂量曲线包绕肿瘤,肿瘤平均周边剂量26.5Gy,平均中心剂量41.0Gy。对术后随访患者的临床症状、血液激素水平和鞍区MRI检查结果进行对比分析。结果随访期3~30个月,平均18月,临床症状改善或消失103例(72.0%),激素水平下降或恢复正常84例(80.8%),肿瘤缩小或消失87例(60.8%),平均肿瘤生长控制率为95.1%。结论伽玛刀放射外科对各种类型垂体腺瘤的治疗是安全有效的,能够改善和控制大部分患者的临床症状、激素水平和肿瘤生长。

Objective To evaluate the effectiveness and complications of gamma knife surgery for treating pituitary adenomas.Methods The clinical data of 143 patients with pituitary adenomas were performed by the gamma knife in our center from January 2010 to December 2013 were analyzed retrospectively.There were 54 prolactin secreting adenomas （ PRL）, 24 growth hormone secreting adenomas （ GH ） , 11 adrenocorticotrophic hormone secreting adenomas （ ACTH ） , 15 prolactin/growth secreting hormone （ PRL/GH ） adenomas and 39 non-functional adenomas. Average maximum tumor diameter was 26.3mm （2 ~64mm）.The average does in the center of tumor was 41.0Gy and the average does was 26.5Gy with 30%~70%isodoes line.Results 143 patients were followed up with an average follow-up period of 18 months （3~30 months） .Clinical symptoms of 103 （ 72.0%） patients were released or disappeared.Improved endocrine status occurred in 84 cases（80.8%）.87（60.8%） patients experienced arrest of tumor growth.Average control rate was 95.1%.Conclusion Gamma knife radiosurgery is a safe and effective therapeutic method of achieving clinical symptoms control, endocrine remission/stability and tumor growth control in pituitary adenomas.