垂体瘤立体定向放射外科治疗临床观察

Stereotactic Radiosurgery for Pituitary Tumors

摘要: 目的　分析报告微小垂体腺瘤 SRS治疗观察结果。方法　 94年 8月至 98年 8月对1 8例经挑选的垂体瘤实施了 SRS治疗。中位肿瘤最大直径为 1 0 mm,中位年龄 34岁, 中位肿瘤边缘剂量 2 0 Gy。结果　 87.5% (1 4/1 6)的病例获得临床症状改善, 1 2 .5% (2 /1 6)无变化。影象学观察结果显示 37.5% (6/1 6)肿瘤缩小 ;56.3% (9/1 6)肿瘤体积无变化。 2 1 .4% (3/1 4)激素水平在 SRS治疗后 1年降至正常, 57.1 % (8/1 4)激素水平有所下降, 2 1 .4% (3/1 4)未变。结论　肿瘤周边剂量1 8～ 2 2 Gy为安全有效的治疗剂量。建议谨慎掌握对年轻病人 SRS剂量, 对体积较大、有明显侵袭性、紧贴视神经的垂体瘤应以显微外科或者立体定向分次照射为首选治疗手段。

Abstract: Objective Report the clinical result of SRS for pituitary adenoma. Methods 18 selected pituitary tumors were treated with SRS between Aug 1994 to Aug 1998.The median tumor diameter was 10mm,median SRS target volum was 1.37mm\+3,median margine target dose was 20Gy. Results The median follow-up period was 47 months,87.5% cases obtained clinical improvement and 78.5% obtained hormone level lowered,37.5% show reduction of tumor size,only 1 PRL-producing adenoma received reoperation for tumor progression.Conclus...