The Long-Term Result of Gamma Knife Treatment for Pituitary Adenoma_West China Medical Journal

Authors：

1.Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China; 2.Department of Neurosurgery, the Affiliated Hospital of Chengdu Agency of Tibet Government, Chengdu, Sichuan 610041, P.R.China;

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Keywords：

垂體腺瘤; 伽瑪刀; 療效

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【摘要】目的 探討伽瑪刀治療垂體腺瘤遠期腫瘤控制及并發癥發生情況。方法 2004年6月-2006年12月共158例垂體腺瘤患者接受伽瑪刀治療。伽瑪刀治療邊緣劑量12～30 Gy，以45%~70%等劑量曲線覆蓋腫瘤灶。術后定期對患者進行門診隨訪和鞍區增強MRI掃描，記錄腫瘤控制及并發癥發生情況。結果 131例患者完成隨訪，平均隨訪時間49個月。至隨訪結束，共7例患者腫瘤增大復發。伽瑪刀治療后1、2、3、4及5年腫瘤控制率分別為95.8%、95.8%、95.8%、95.8%及93.9%。46例患者（35.1%）在治療后出現暫時性頭痛和感覺異常，對癥處理后緩解；4例患者（3.1%）出現垂體功能低下，接受激素替代治療。未觀察到其他顱神經和血管損害表現。結論伽瑪刀治療垂體瘤遠期療效肯定，并發癥輕微，是一種安全可靠的垂體瘤治療手段。
【Abstract】 Objective To explore the long-term tumor control and side effects of gamma knife treatment for pituitary adenoma. Methods One hundred and fifty-eight patients with pituitary adenoma undergone gamma knife treatment were periodically followed up from June 2004 to December 2006. The prescript radiation dosage was 12-30 Gy. An enhanced MRI scan was scheduled every 6-12 months after the treatment. The tumor sizes of different scan were compared and the side effects were recorded. Results One hundred and thirty-one patients finished the follow-up procedure with an average time of 49 months. One hundred and twenty-four patients received good tumor control at the end of the research and recurrence was seen in seven patients. The 1-, 2-, 3-, 4-, and 5- year tumor control rates were 95.8%, 95.8%, 95.8%, 95.8%, and 93.9% respectively. Forty-six patients showed temporal and were relieved after treatment. Hypopituitarism was seen in four patients but no cranial nerve or vascular damage was detected. Conclusion The long-term effect of gamma knife therapy for pituitary adenoma remains good and the incidence of side effects is low. Gamma knife therapy could be a safe and effective choice for pituitary adenoma treatment.

Citation： LI Peng,WANG Wei,YANG Wei,MAO Boyong,WANG Xing,ZHONG Qi,REN Haibo. The Long-Term Result of Gamma Knife Treatment for Pituitary Adenoma. West China Medical Journal, 2010, 25(9): 1638-1640. doi: Copy

1.	Ganz JC. Gamma knife treatment of pituitary adenoma[J]. Stereotaet Funct Neurosurg, 1993, 64(1): 3-10.
2.	Sheehan JP, Kondziolka D, Flickinger J, et al. Radiosurgery for residual or recurrent nonfunctioning pituitary adenoma[J]. J Neurosurg, 2002, 97(Suppl 5): 408-414.
3.	Petrocich Z, Yu C, Giannotta SL, et al. Gamma knife radiosurgery for pituitary adenoma: early results[J]. Neurosurgery, 2003, 53: 51-59.
4.	Sharma BS, Sinha S, Suri A. Treatment of giant pituitary adenomas[J]. Neurosurg Quarterly, 2007, 17(2): 120-127.
5.	Feigl GC, Bonelli CM, Berghold A, et al. Effects of gamma knife radiosurgery of pituitary adenomas on pituitary function[J]. J Neurosurg, 2002, 97 (5 suppl): 415-421.
6.	王宏偉, 張國榮, 劉沙, 等. 巨大垂體腺瘤的伽瑪刀治療(附42例報道)[J]. 立體定向和功能性神經外科雜志, 2005, 18(5): 299-301.
7.	李素敏, 趙慶秋, 杜亞麗. 立體定向放射治療腦垂體瘤344例遠期療效觀察[J]. 臨床薈萃, 2007, 22(12): 846-848.
8.	潘棉順, 王鵬, 朱世友, 等. 伽瑪刀放射外科治療垂體大腺瘤臨床研究[J]. 中國神經腫瘤雜志, 2007, 5(2): 99-102.
9.	梁軍潮, 徐波濤, 吳鴻勛, 等. 伽瑪刀治療垂體微腺瘤遠期對垂體功能的影響[J]. 中國神經腫瘤雜志, 2006, 4(1): 40-43.
10.	Laws ER, Sheehan JP, Sheehan JM, et al. Stereotactic radiosurgery for pituitary adenomas: a review of the literature[J]. J Neurooncol, 2004, 69(1-3): 257-272.

1. Ganz JC. Gamma knife treatment of pituitary adenoma[J]. Stereotaet Funct Neurosurg, 1993, 64(1): 3-10.
2. Sheehan JP, Kondziolka D, Flickinger J, et al. Radiosurgery for residual or recurrent nonfunctioning pituitary adenoma[J]. J Neurosurg, 2002, 97(Suppl 5): 408-414.
3. Petrocich Z, Yu C, Giannotta SL, et al. Gamma knife radiosurgery for pituitary adenoma: early results[J]. Neurosurgery, 2003, 53: 51-59.
4. Sharma BS, Sinha S, Suri A. Treatment of giant pituitary adenomas[J]. Neurosurg Quarterly, 2007, 17(2): 120-127.
5. Feigl GC, Bonelli CM, Berghold A, et al. Effects of gamma knife radiosurgery of pituitary adenomas on pituitary function[J]. J Neurosurg, 2002, 97 (5 suppl): 415-421.
6. 王宏偉, 張國榮, 劉沙, 等. 巨大垂體腺瘤的伽瑪刀治療(附42例報道)[J]. 立體定向和功能性神經外科雜志, 2005, 18(5): 299-301.
7. 李素敏, 趙慶秋, 杜亞麗. 立體定向放射治療腦垂體瘤344例遠期療效觀察[J]. 臨床薈萃, 2007, 22(12): 846-848.
8. 潘棉順, 王鵬, 朱世友, 等. 伽瑪刀放射外科治療垂體大腺瘤臨床研究[J]. 中國神經腫瘤雜志, 2007, 5(2): 99-102.
9. 梁軍潮, 徐波濤, 吳鴻勛, 等. 伽瑪刀治療垂體微腺瘤遠期對垂體功能的影響[J]. 中國神經腫瘤雜志, 2006, 4(1): 40-43.
10. Laws ER, Sheehan JP, Sheehan JM, et al. Stereotactic radiosurgery for pituitary adenomas: a review of the literature[J]. J Neurooncol, 2004, 69(1-3): 257-272.

West China Medical Journal

The Long-Term Result of Gamma Knife Treatment for Pituitary Adenoma

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