Xiao Qi-Hua, Huang Si-Qing, Mao Bo-Yong, Li Guo-Ping, Ju Yan
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Ai Zheng. 2007 Jul;26(7):742-7.
BACKGROUND & OBJECTIVE: Pituitary adenoma, a kind of familiar benign intracranial tumor, is mainly treated with surgical operation, medication, and radiation. However, the outcome, especially for giant pituitary adenoma, is not very satisfactory. This study was to explore the efficacy of total tumor removal or subtotal tumor removal combined gamma knife radiation on giant pituitary adenoma.
Clinical data of 160 giant pituitary adenoma patients were analyzed. Of the 160 patients, 90 received total tumor removal, 70 received subtotal tumor removal combined gamma knife radiation. The symptom improvement, tumor size change, serum hormone concentration, complications after treatment, and so on, of the 2 groups were compared.
At 12 months after treatment, the efficiency rate, recurrence rate, and mortality were 74.4%, 31.1%, and 3.3%, respectively, in total tumor removal group; however, the efficiency rate reached 91.4%, the recurrence rate decreased to 11.4%, and no patients died in combined therapy group. The follow-up results at 24 months after treatment and at present (over 5 years) showed that though the efficiency rate had descended and recurrence rate or mortality had ascended in both groups, the efficacy of combined therapy was obviously better than that of total tumor removal. The decrease of serum hormone concentration was more obvious in combined therapy group than in total tumor removal group at 12 months after treatment. Moreover, total tumor removal group had more serious complications than combined therapy group after treatment.
Subtotal tumor removal combined gamma knife radiation is better than total tumor removal for giant pituitary adenoma.
垂体腺瘤是一种常见的颅内良性肿瘤，主要治疗方法有手术、药物及放疗。然而，其治疗效果，尤其是巨大垂体腺瘤的治疗效果并不十分理想。本研究旨在探讨全切除或次全切除联合伽玛刀放疗对巨大垂体腺瘤的疗效。
分析160例巨大垂体腺瘤患者的临床资料。其中90例行全切除，70例行次全切除联合伽玛刀放疗。比较两组患者的症状改善情况、肿瘤大小变化、血清激素浓度、治疗后并发症等。
治疗后12个月，全切除组有效率、复发率和死亡率分别为74.4%、31.1%和3.3%；而联合治疗组有效率达91.4%，复发率降至11.4%，无患者死亡。治疗后24个月及目前（超过5年）的随访结果显示，尽管两组有效率均有所下降，复发率或死亡率均有所上升，但联合治疗的疗效明显优于全切除。治疗后12个月，联合治疗组血清激素浓度下降比全切除组更明显。此外，治疗后全切除组并发症比联合治疗组更严重。
对于巨大垂体腺瘤，次全切除联合伽玛刀放疗优于全切除。
