直线加速器放射外科治疗经蝶窦手术后复发的库欣病：5例病例系列
LINAC radiosurgery in recurrent Cushing's disease after transsphenoidal surgery: a series of 5 cases.
作者信息
Wong G K, Leung C H, Chiu K W, Ma R, Cockram C S, Lam M J, Poon W S
机构信息
Division of Neurosurgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
出版信息
Minim Invasive Neurosurg. 2003 Dec;46(6):327-30. doi: 10.1055/s-2003-812497.
INTRODUCTION
Oversecretion of ACTH from pituitary adenomas is associated with morbidity and reduced life expectancies. We hypothesized that radiosurgical treatment may provide effective tumour and hormonal control associated with minimal pituitary insufficiency.
METHOD
Data of five patients who underwent LINAC radiosurgery for recurrent or residual Cushing's disease between 1999 and 2002 were prospectively collected.
RESULT
Follow-up period ranged from 27 to 49 months (mean 38 months). All patients attained remission in 6-18 months (mean 8.4 months). One patient (20 %) developed biochemical recurrence 12 months after remission. One patient (20 %) developed hydrocortisone deficiency 24 months after radiosurgery. None of the patients had new visual field defect detected on follow-up.
CONCLUSION
In this small case series, LINAC radiosurgery was shown to be an effective and safe treatment of persistent or recurrent Cushing's disease following transsphenoidal surgery. Long-term follow-up and larger patient series is recommended for further clarification.
引言
垂体腺瘤分泌促肾上腺皮质激素过多与发病率和预期寿命缩短有关。我们推测放射外科治疗可能有效控制肿瘤和激素水平，同时使垂体功能不全降至最低。
方法
前瞻性收集了1999年至2002年间因复发性或残留性库欣病接受直线加速器放射外科治疗的5例患者的数据。
结果
随访期为27至49个月（平均38个月）。所有患者在6至18个月（平均8.4个月）内病情缓解。1例患者（20%）在缓解后12个月出现生化复发。1例患者（20%）在放射外科治疗后24个月出现氢化可的松缺乏。随访期间未发现患者有新的视野缺损。
结论
在这个小病例系列中，直线加速器放射外科治疗被证明是经蝶窦手术后持续性或复发性库欣病的一种有效且安全的治疗方法。建议进行长期随访和纳入更多患者系列以进一步明确。
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