摘要
目的 总结 5 8例功能性垂体腺瘤的X刀治疗与随访资料 ,评价其疗效、探讨治疗方法。方法 PRL腺瘤 4 3例 ,GH腺瘤 7例 ,混合性腺瘤 8例。肿瘤最大直径 1.32± 0 .2 6cm ,体积 1.11± 1.0 6cm3。周边剂量 17.93± 4 .5 6Gy。结果 随访 12～ 83月 ,平均 4 5 .38月 ,临床有效率 96 .5 5 % ,肿瘤控制率 10 0 % ,消失率 79.31%。内分泌功能改善率 10 0 % ,正常率 4 8.2 7% ,激素水平与治疗前激素水平和病变体积呈正相关 ,2 3/ 5 0例PRL和 7/ 11例GH有一过性反跳现象。结论 X刀是一种安全、有效的功能性垂体腺瘤治疗手段。高分泌性腺瘤可采用多靶点、高剂量治疗 ,大腺瘤应严格掌握指证 ,宜多靶点、分次或配合药物治疗。推崇垂体腺瘤分次X刀治疗的开展。
Objective To evaluate the efficacy of X-knife on functional pituitary adenoma,and study the treatment methodology.Methods The data of 58 patients with functional pituitary adenomas,treated with X-knife and followed up more than one year,are analyzed.This included 43 prolactinomas,7 growth hormone (GH) secreting adenomas,8 mixed-functional adenomas.The tumor diameter was 1.32±0.26cm.The tumor volume was 1.11±1.06cm 3.The margin dose was 17.93±4.56Gy.Results After a follow-up of 45.38±14.56 months,19 patients regained menstruation,36 patients had eumenorrhea,29 patients stop lactating,8 patients achieved pregnancy and 8 patients experienced improvement of acromegaly.The clinical improvement rate was 96.55%.The imaging followed-up indicated that the tumors were vanished in 46 cases,necrotic and shrinking in 12 cases.The local tumor control was 100%.And the rate of disappearance was 79.31%.The over-secreting hormones were normalized in 28 cases,and decreased in 30 cases.The rate of hormone improvement was 100%.And the rate of normalization was 48.27%.The serum hormone level was in positive relation to the pre-therapeutic hormone level and pre-therapeutic tumor volume.The short-duration bounce of serum hormone was observed in 23/50 PRL secreting and 7/11 GH secreting patients.Conclusion X-knife is a safe,effective therapeutics for the functional pituitary adenoma.The multi-target,high-dose therapeutics are suitable for the excessive secreting pituitary adenomas.It should be rigorous to take the large functional pituitary adenoma as indication for X-knife.The multi-target,fractionated stereotactic radiotherapy (FSRT) and combined pharmacotherapy are fit for large pituitary adenomas.The optimal prescription dose and FSRT on functional pituitary adenoma are in needs of further study.And FSRT should be more broadly used.
出处
《立体定向和功能性神经外科杂志》
2004年第4期210-213,共4页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
垂体腺瘤
X刀
立体定向放射外科
疗效
方法学
Pituitary adenoma
X-knife
Stereotactic radiosurgery
Effects
Methodology
