摘要
目的 评价伽玛刀治疗无功能型垂体腺瘤的适应证和疗效。方法 随访255例伽玛刀治疗后的无功能型垂体腺瘤,分成单纯伽玛刀治疗组与外科手术后加伽玛刀治疗组,平均随访时间34.2个月(6—90个月)。单纯伽玛刀治疗组187例,平均周边剂量14.6Gy;手术加伽玛刀治疗组68例,平均周边剂量13.5Gy。结果 单纯伽玛刀治疗的187例无功能型垂体腺瘤中,肿瘤缩小127例(67.9%),肿瘤大小无变化的56例(29.9%),肿瘤增大4例(1.2%)。术后肿瘤残留或复发加伽玛刀治疗的68例无功能型垂体腺瘤中,肿瘤缩小45例(66.2%),肿瘤大小无变化21例(30.9%),肿瘤增大2例(2.9%)。本组随访255例肿瘤总控制率97.6%,出现新的垂体功能低下7例。结论 伽玛刀治疗无功能型垂体腺瘤是有效和安全的,特别是开颅术后肿瘤残留和复发的病人,并发症少,优于常规放疗。
Objective To evaluate the indication and efficiency of nonfunctioning pituitary adenoma managed by γ-knife. Methods Totally 255 cases of γ-knife managed nonfunctioning pituitary adenoma patients were followed up by a mean time of 34.2 months ( from 6 months to 90 months). The patients were devided into groups according to the manage modality, γ-knife alone group and γ-knife in combination with neurosurgery group. The mean tumor margin dose was 14.6Gy and 13.5Gy respectively for the 187 cases managed by γ-knife alone and 68 cases managed by γ-knife in combination with neurosurgery. Results 127 patients (67.9%) showed tumor volume descrease and 56 patients (29.9%) showed no tumor volume change in the 187 cases of γ-knife alone managed group. 4 patients ( 1. 2% ) showed tumor volume increase. 45 patients (66.2%) showed tumor volume decrease and 21 patients (30.9%) showed no tumor volume change and 2 patients ( 2.9% ) showed tumor volume increase in the 68 cases of patients first treated by craniotomy and then by γ-knife because of tumor residue or recurrence. The overall tumor control rate were 97.6% with 7 cases of new developed hypopituitarism patients. Conclusions γ-knife is an efficient and safe modality for nonfunctioning pituitary adenomas with few complications, especially for patients with tumor residue or recurrence after craniotomy.
出处
《中华神经外科杂志》
CSCD
北大核心
2007年第2期131-134,共4页
Chinese Journal of Neurosurgery
关键词
伽玛刀
垂体腺瘤
无功能型
γ-knife
Pituitary adenoma, nonfunctioning