542例垂体大腺瘤伽玛刀“剂量权重偏心法”治疗效果及安全性评估

Efficacy and Safety of Gamma Knife Radiosurgery Based on Dose Weighting Eccentric Method in Pituitary Macroadenoma:an Analysis of 542 Cases

目的研究伽玛刀"剂量权重偏心法"治疗垂体大腺瘤的疗效及其并发症。方法对542例采用伽玛刀"剂量权重偏心法"治疗的垂体大腺瘤患者进行随访,随访内容包括影像学变化、激素水平以及术后不良反应。结果542例垂体大腺瘤患者术后平均随访时间36个月。肿瘤缩小/中心坏死509例(93.91%),肿瘤无变化25例(4.61%),肿瘤增大8例(1.48%);肿瘤有效控制率为98.52%。334例功能性腺瘤中激素水平恢复正常/下降患者292例(87.2%),升高42例(12.57%)。术后不良反应:24.72%患者出现头痛(134/542),未发现视力下降和垂体功能低下。结论伽玛刀"剂量权重偏心法"治疗垂体大腺瘤具有安全性高、疗效好、并发症少等优点。

Objective To investigate the efficacy and complications of gamma knife radiosurgery for pituitary macroadenoma based on dose weighting eccentric method.Methods A total of 542 patients treated with gamma knife radiosurgery for pituitary macroadenoma were followed up with imaging manifestations,hormone levels and postoperative adverse reactions.Results The mean follow-up period was 36 months.Among the 542 patients,tumor shrinkage or central necrosis occurred in 509(93.91%),no change in tumor in 25(4.61%),and tumor enlargement in 8(1.48%).The total effective rate of tumor control was 98.52%.Of the 334 cases with functional adenoma,hormone levels returned to normal or decreased in 292(87.42%),but increased in 42(12.57%).After operation,134 patients(24.72%)had headache.No hypopituitarism and vision impairment were found in all patients.Conclusion Gamma knife radiosurgery based on dose weighting eccentric method is safe and effective for pituitary macroadenoma and results in less complications.