Petrovich Zbigniew, Jozsef Gabor, Yu Cheng, Apuzzo Michael L J
Department of Radiation Oncology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, NOR G356, Los Angeles, CA 90033-0804, USA.
Neurosurg Clin N Am. 2003 Jan;14(1):147-66. doi: 10.1016/s1042-3680(02)00031-1.
Based on a review of the literature and our medical center experience, we believe that transphenoidal surgery is the procedure of choice in most patients with pituitary adenomas. Conversely, SRS is a procedure of choice for those with cavernous sinus involvement. Patients with incomplete surgical excision should be considered either for a planned stereotactic treatment or for external beam radiotherapy. The same applies to patients with recurrent tumors. We favor stereotactic treatment in patients who have tumors that are less than 35 mm in diameter and at least 3 mm from the chiasm or optic nerves. Other patients should be considered for three-dimensional conformal radiotherapy. Radiotherapy provides a good treatment alternative in those patients who either refuse surgery or have contraindications to this therapy. Contemporary radiotherapy and SRS for pituitary adenomas is safe and effective treatment. This treatment should be undertaken in medical centers with appropriate expertise and instrumentation.
基于文献回顾和我们医疗中心的经验，我们认为经蝶窦手术是大多数垂体腺瘤患者的首选治疗方法。相反，立体定向放射外科（SRS）是海绵窦受累患者的首选治疗方法。手术切除不完全的患者应考虑进行计划性立体定向治疗或外照射放疗。复发性肿瘤患者也是如此。对于直径小于35mm且距视交叉或视神经至少3mm的肿瘤患者，我们倾向于立体定向治疗。其他患者应考虑三维适形放疗。放疗为那些拒绝手术或有手术禁忌证的患者提供了一种很好的治疗选择。当代垂体腺瘤的放疗和立体定向放射外科是安全有效的治疗方法。这种治疗应在具备适当专业知识和仪器设备的医疗中心进行。
