【摘要】 目的:评价垂体腺瘤患者接受常规放射治疗后的长期疗效和毒性;探讨影响疗效的因素。方法:从1988年1月到1998年1月共收治96例垂体腺瘤患者行常规放射治疗。44例分泌激素,52例不分泌激素,73例为术后放射治疗,23例为复发放射治疗;50例采用钴60线照射,46例采用6MV X线照射;平均照射剂量45Gy(43.2Gy至50.0Gy);全组中位随访时间6.5年(0.8年至20.0年),存活患者中位随访时间6.1年(2.0年至20.0年)。结果:全组无功能性腺瘤和功能性腺瘤10年局控率分别为96.2%和72.7%(P=0.001),10年疾病专项生存率(CSS)分别为94.2%和88.6%(P=0.319),10年总生存率分别为69.2%和77.3%(P=0.395)。激素分泌显著降低局控率(P=0.012);蝶窦受累降低10年CSS(P=0.039),CSS与激素分泌、手术范围、术后或复发放疗无明显相关。35例患者出现垂体功能减退:视力丧失和继发性脑胶质瘤各2例。结论:适当剂量的放射治疗能使切除不全或术后复发的垂体腺瘤患者获得满意的长期控制率,严重并发症相对较少;激素分泌、蝶窦受累显著影响疗效。更多还原

【Abstract】 Objective:To evaluate long-term local control and toxicity for pituitary adenomas treated with fractionated radiotherapy(RT) and explore the influencing factors for effect.Methods:Ninety-six patients with pituitary adenomas treated between 1988 and 1998 were retrospectively reviewed.Forty-four patients had hormone-secreting tumors;73 patients were treated with surgery and postoperative RT;50 patients were treated with Co60γ ray,46 patients with 6MV X ray.The mean dose delivered was 45 Gy(range,43.2-50.0 Gy).Median follow-up was 6.5 years(range,0.8-20.0 years) for all patients and 6.1years(range,2-20.0 years) for living patients.Results:The 10-year local control rates were 96.2% and 72.7%(P=0.001),10-year cause-specific survival(CSS) rates were 94.2% and 88.6%(P=0.319),and overall survival rates were 69.2% and 77.3%(P=0.395) for nonsecreting and secreting adenomas,respectively.Involvement of the sphenoid sinus was found to be significantly associated with decreased 10-year CSS(p=0.039).CSS was not significantly associated with hormone excretion,extent of surgery,or whether RT was administrated postoperatively or for salvage after a postsurgical recurrence.New cases of hypopituitarism occurred in 35 patients.Two patients experienced vision loss,and 2 patients developed a post-treatment glioma.Conclusions:Moderate dose RT can provide excellent long-term tumor control for patients with incompletely resectable or recurrent tumors after surgery.Hormone excretion and involvement of sphenoid sinus was found to be significantly associated with long-term effectiveness.更多还原