垂体腺瘤的伽玛刀治疗

目的：评价垂体腺瘤的伽玛刀治疗在控制肿瘤生长和改善内分泌异常方面的作用和疗效。方法：对228例垂体腺瘤患者采用1.0TMRI和Gamma-Plan计划系统联网定位，Leksell-B型伽玛刀实施放射外科治疗，治疗周边剂量12~35 Gy，平均21.3 Gy（NFA:15.9 Gy；FA:27.6 Gy），中心剂量24~70 Gy，平均46.6 Gy（NFA:31.8 Gy；FA:50.3 Gy）。 结果：116例随访4~67个月，平均27.4个月，113例（97.4%）肿瘤生长得到控制。98例（84.5%）肿瘤体积缩小50%以上，肿瘤体积增大3例(2.6%)。分泌功能腺瘤伽玛刀治疗后内分泌症状改善率89.8%，激素水平正常化为49.7%。并发症6%。结论：伽玛刀治疗垂体腺瘤，具有创伤小、安全、并发症少的优点，且在控制肿瘤生长和改善内分泌异常方面疗效确切。

Gamma knife treatment for pituitary adenomas

OBJECTIVE: To evaluate the function and effect of Gamma knife radiosurgery (GKR) in controlling the tumor growth and improving endocrinological abnormality of pituitary adenomas. METHODS: Two hundred and twenty-eight cases of pituitary adenoma were treated with Leksell Gamma knife. 1.0 Tesla MRI and Gamma-Plan system were used to orientate the tumor. The margin dose was 12 - 35 Gy, mean 21.3 Gy; the center does was 24 - 70 Gy, mean 46.6 Gy (NFA, 31.8 Gy; FA, 50.3 Gy). RESULTS: One hundred and sixteen cases (NFA, 28; FA, 88) were followed up for 4 - 67 months, and the mean was 27.4 months. The growth of tumors in 113 cases (97.4%) was controlled. The tumor volume became smaller in 98 cases (84.5%). Three cases (2.6%) grew larger in tumor size. A significant decrease of excessive hormone production was seen in 89.8% of the patients, and the endocrinological normalization rate was 49.7% (PRL, 47.2%; GH, 57.1%; ACTH, 55.6%). Postradiosurgical complications were seen in 6%. CONCLUSION: Gamma knife radiosurgery is safe and effective in controlling the tumor growth and improving endocrinological abnormality of pituitary adenoma.