Kim Mooseong, Paeng Sunghwa, Pyo Seyoung, Jeong Yeonggyun, Lee Sunil, Jung Yongtae
Department of Neurosurgery, College of Medicine, Inje University Busan Paik Hospital, Busan, Korea.
J Neurosurg. 2006 Dec;105 Suppl:26-30. doi: 10.3171/sup.2006.105.7.26.
Pituitary adenomas have been treated using a variety of modalities including resection, medication, fractionated radiotherapy, and stereotactic radiosurgery. The policy has been that all adenomas should first be treated with resection to reduce the volume of the tumor. The authors' study was conducted to determine the efficacy of using Gamma Knife surgery (GKS) for pituitary adenomas invading the cavernous sinus.
Of 397 patients with pituitary tumors who underwent GKS between October 1994 and October 2005, 68 patients had pituitary macroadenomas invading the cavernous sinus. Sixty-seven cases were available for follow up. The mean age of the patients in these cases was 42.8 years (range 14-73 years). The male/female ratio was 0.8:1. The mean adenoma volume was 9.3 cm3. A total of 24 patients had undergone craniotomies and resection, and 11 patients had undergone transsphenoidal surgery prior to GKS. The mean follow-up period was 32.8 months. Tumor control was defined as a decrease or no change in tumor volume after GKS. Endocrinological improvement was defined as a decline in hormone levels to below 50% of the pre-GKS level. Tumor control was achieved in 95.5% of the cases. Endocrinological improvement was achieved in 68% of 25 patients. One patient suffered hypopituitarism after GKS.
Gamma Knife surgery is a safe and effective treatment for invasive pituitary macroadenoma with few complications.
垂体腺瘤的治疗方式多种多样，包括手术切除、药物治疗、分次放疗和立体定向放射外科治疗。一直以来的策略是，所有腺瘤都应首先接受手术切除以缩小肿瘤体积。作者开展这项研究是为了确定伽玛刀手术（GKS）治疗侵犯海绵窦的垂体腺瘤的疗效。
在1994年10月至2005年10月期间接受GKS的397例垂体肿瘤患者中，68例为侵犯海绵窦的垂体大腺瘤。67例可供随访。这些病例中患者的平均年龄为42.8岁（范围14 - 73岁）。男女比例为0.8:1。腺瘤平均体积为9.3立方厘米。共有24例患者在GKS之前接受过开颅手术和切除术，11例患者接受过经蝶窦手术。平均随访期为32.8个月。肿瘤控制定义为GKS后肿瘤体积减小或无变化。内分泌功能改善定义为激素水平降至GKS前水平的50%以下。95.5%的病例实现了肿瘤控制。25例患者中有68%实现了内分泌功能改善。1例患者在GKS后出现垂体功能减退。
伽玛刀手术是治疗侵袭性垂体大腺瘤的一种安全有效的方法，并发症较少。
