替莫唑胺治疗难治性垂体腺瘤

Temozolomide therapy for refractory pituitary adenomas

目的探讨替莫唑胺在难治性垂体腺瘤中的疗效。方法回顾性分析近年收治的3例难治性垂体腺瘤患者,包括1例侵袭性无功能腺瘤,1例肢端肥大症,1例库欣病,总结其临床过程及应用替莫唑胺治疗后的效果并结合文献进行分析。结果侵袭性无功能腺瘤患者经12个月替莫唑胺治疗,肿瘤明显缩小,随访1年,未见肿瘤进展;肢端肥大症患者经过6个月治疗,随访3月,肿瘤有所缩小,激素水平无明显下降;库欣病患者经过4个月治疗,肿瘤无明显变化,激素水平无下降。结论替莫唑胺在控制难治性垂体腺瘤大小可能有一定作用,但短疗程的治疗对肢端肥大症和库欣病患者的激素水平控制效果不理想,日后仍需继续研究。

Objective To investigate the efficacy of temozolomide in refractory pituitary adenomas.Methods Three patients with non⁃functional pituitary adenoma or acromegaly,or Cushing′s disease was retrospectively reviewed and analyzed with the literature.Results The patient with invasive non⁃functional pituitary adenoma were responded to 12 months of the temozolomide treatment.The tumor size continue to be stable at 1 year follow⁃up.In the patient with acromegaly,there was a decrease in the tumor size without a concomitant decline in the GH concentration aftersixcyclestreatment.For the patient with Cushing′s disease,hypercortisolism remained with the tumor size stable.Conclusion Temozolomide may play a role in controlling the tumors size.However,the short⁃term treatment could not achievehor⁃monal responsesin patients with acromegaly or Cushing′s disease.Further research is needed in the future.