垂体生长激素腺瘤伽玛刀治疗的预后及相关因素分析

目的评估立体定向伽玛刀对垂体生长激素腺瘤的治疗效果，并分析预后的相关影响因素。方法回顾性分析垂体生长激素腺瘤应用伽玛刀治疗病例90例，统计分析治疗效果及其与服用生长抑素类药物、边缘剂量、术前生长激素（GH）水平、肿瘤体积大小之间的关系。结果所有病例平均随访51．5个月，生长激素水平恢复正常者46例，治愈率51．1％；生长激素〈5．0μg/L者78例，有效控制率86．7％；84例患者肿瘤缩小明显，有效控制率为93．3％；13例（14．4％）出现垂体功能低下。结论伽玛刀是一种治疗垂体生长激素腺瘤的有效方法；服用生长抑素类药物、术前GH水平、边缘剂量是预后的明显影响因素；肿瘤体积与疗效没有显著的相关性。

Therapeutic efficacy of GKS for GH-secreting pituitary adenomas:the relative factors associated with prognosis

Objective To evaluate the therapeutic efficacy of gamma knife radiosurgery （GKS） for growth hormone-secreting pituitary adenomas and to investigate the prognosis-related factors. Methods The clinical data of 90 cases were analyzed retrospectively. The relationship between the efficacy and pituitary suppressive medication administration, preradiosurgery growth hormone （GH） level, peripheral dose and tumor size were analyzed. Results All patients were followed-up with a median of 51.5 months after radiosurgery, Forty-six patients got biochemical remission with a cure rate of 51.1% ; GH levels of 78 cases decreased to less than 5 μg/ L with an effective control rate of 86.7% ; tumor volume of 84 cases decreased with an effective control rate of 93.3%. The incidence of new anterior pituitary deficits was 14.4%. Conclusion GKS is an effective method in treating GH-secreting pituitary adenomas. Pituitary suppressive medication administration, preradiosurgery GH level and peripheral dose are important factors to evaluate the prognosis of GKS. Tumor size, however, has no significant correlation with the efficacy.