Rush S, Donahue B, Cooper P, Lee C, Persky M, Newall J
Division of Radiation Oncology, North Shore University Hospital, Manhassett, New York.
Neurosurgery. 1991 Apr;28(4):502-5. doi: 10.1097/00006123-199104000-00003.
The ability of surgery or bromocriptine to produce endocrine control of a prolactin macroadenoma decreases as the prolactin level increases. Guidelines for the use of multimodality therapy have not been developed for tumors associated with markedly elevated prolactin levels. We reviewed the records of 21 patients with prolactin levels greater than 200 ng/ml treated by transsphenoidal surgery and postoperative radiotherapy with or without a dopamine agonist. Values before and after treatment were available for 19 patients (13 men and 6 women). The mean basal prolactin level before treatment for the entire group was 2410 ng/ml. Surgery and radiotherapy resulted in a 90% reduction and serum prolactin levels within normal limits in 0 of 7 patients, versus the combination of surgery, radiotherapy, and dopamine agonist, which resulted in a 99.5% reduction and values within the normal range in 12 of 12 patients. Spontaneous physiological improvement was not often observed. One woman and two men were able subsequently to have children. A plan for these patients is discussed.
随着催乳素水平升高，手术或溴隐亭实现催乳素大腺瘤内分泌控制的能力会降低。对于催乳素水平显著升高相关的肿瘤，尚未制定多模式治疗的使用指南。我们回顾了21例催乳素水平大于200 ng/ml的患者记录，这些患者接受了经蝶窦手术及术后放疗，部分患者联合或未联合多巴胺激动剂治疗。19例患者（13例男性和6例女性）有治疗前后的数据。整个组治疗前的平均基础催乳素水平为2410 ng/ml。手术和放疗使7例患者中的0例催乳素水平降低了90%且降至正常范围，而手术、放疗和多巴胺激动剂联合治疗使12例患者中的12例催乳素水平降低了99.5%且降至正常范围。未经常观察到自发的生理改善情况。1名女性和2名男性随后能够生育。文中讨论了针对这些患者的治疗方案。
