Hu Chao-su, Ying Hong-mei, Shen Chun-ying
Department of Radiation Oncology, Cancer Hospital, Fudan University, Shanghai 200032, P. R. China.
Ai Zheng. 2002 Oct;21(10):1154-7.
BACKGROUND & OBJECTIVES: Pituitary adenoma is a common intracranial tumors, and can be treated by surgery or radiotherapy. The aim of this study was to compare the result of pituitary adenoma treated by radiotherapy and surgery combined with radiotherapy.
From March 1980 to January 1992, 68 patients with pituitary adenoma were treated by radiotherapy in our hospital. Sixteen patients were treated by radiotherapy alone and 52 patients were treated by surgery followed with radiotherapy. The median dose was 49.7 Gy. Fourty-five patients were treated with Co60 gamma ray, 10 patients with 8MV X ray and 13 patients with 18MV X ray.
The overall 5- and 10-year survival rates were 94.1% and 76.8%, respectively. The 5- and 10-year local control rates were 94.1% and 88.4%, respectively. The local control rate of patients irradiated more than 50 Gy (94%) was higher than those under 50 Gy (82%), but without statistic significance(P = 0.1796). There were no differences among the different pathology and hormone secreting of the tumor, and rays used. Eight patients died from tumor recurrence, and 6 patients with hypopituitarism, five of them received more than 50 Gy (P = 0.0058).
It is better for patients with pituitary adenoma to be irradiated between 45 Gy approximately 50 Gy. Three fields technique should be recommended.
垂体腺瘤是常见的颅内肿瘤,可通过手术或放疗进行治疗。本研究旨在比较放疗以及手术联合放疗治疗垂体腺瘤的效果。
1980年3月至1992年1月,我院对68例垂体腺瘤患者进行了放疗。其中16例单纯接受放疗,52例接受手术后继发放疗。中位剂量为49.7 Gy。45例患者采用钴60γ射线治疗,10例采用8MV X射线治疗,13例采用18MV X射线治疗。
总体5年和10年生存率分别为94.1%和76.8%。5年和10年局部控制率分别为94.1%和88.4%。照射剂量超过50 Gy的患者局部控制率(94%)高于剂量低于50 Gy的患者(82%),但差异无统计学意义(P = 0.1796)。肿瘤的不同病理类型、激素分泌情况以及所使用的射线之间无差异。8例患者死于肿瘤复发,6例出现垂体功能减退,其中5例接受的照射剂量超过50 Gy(P = 0.0058)。
垂体腺瘤患者照射剂量在45 Gy至50 Gy之间效果较好。推荐采用三野技术。