【摘要】 目的术后残余的垂体腺瘤经伽玛刀治疗后可以减少肿瘤的复发率,作者评价了其效果和安全性。方法本组共108例患者,男51例,女57例,年龄21岁至75岁,平均37.53±1.78岁。6个月和12个月随访资料收集包括:MRI、内分泌检查、视力视野检查,以后每年一次的上述检查。结果平均随访时间52.6±3.4个月。5年内未复发者为97%(95%的可信区间为73.8%~100%)。在最后一次复查时肿瘤体积由2.6±0.4cm3减少为1.8±0.3cm3(P<0.001)。47例病人(43.5%)瘤体的减少大于20%,肿瘤缩小患者的处方剂量显著高于其他患者。无视力障碍和其它神经功能障碍等并发症。部分病例出现了垂体功能低下的情况,性功能低下、甲状腺功能低下和肾上腺功能低下和生长激素缺乏的发生率分别为5.6%4、.6%2.7%和1.9%。结论伽玛刀在治疗经手术残余的无功能性垂体腺瘤方面效果是明显的,与普通放疗比较其优势主要是副作用发生率低,尤其是垂体功能低下的发生率大大降低。更多还原

【Abstract】 Objective To evaluate the effect and safety of gamma knife surgery in patients with residual residual pituitary after surgical debulking.Methods 108 patients,51 men and 57 women,ranging in age from 21 to 75 years underwent gamma knife treatment.Baseline and follow-up studies involved magnetic resonance imaging,hormone evaluation,and neuroophthalmological examination 6 and 12 months after GKS and at yearly intervals thereafter.Results The mean follow up after GKS was 52.6±3.4 months.The recurrence-free interval at 5 years was 97.0%(95% confidence interval 73.8%~100%).Tumor volume decreased from a baseline value of 2.6±0.4cm~3 to 1.8±0.3cm~3 at the last follow up(P<0.001).Forty-seven patients(43.5%) had a 20% or greater reduction in tumor volume.The administered radiation dose had been significantly higher in patients who experienced tumor reduction.Visual function and motility did not deteriorate in any patient.New cases of hypogonadism,hypothyroidism,hypoadrenalism and GHdeficit occurred in 5.6%,4.6%,2.7%and 1.9%.Conclusion Gamma knife surgery was effective in controlling the growth of residual pituitary adenomas after previously performed maximal surgical debulking.The major advantage of GKS compared with fractionated radiotherapy seems to be a lower risk of side effects,especially a lower risk of hypopituitarism.更多还原