Neuroscience Institute & Brain Tumor Center, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California, USA.
Can J Neurol Sci. 2011 Jan;38(1):12-21.
Selective transsphenoidal adenomectomy is generally recommended for initial treatment of Cushing's disease (CD) because it achieves a high (70-85%) rate of remission. However, if initial surgery is not successful, the approach to persistent or recurrent CD is more complex. Because residual or recurrent adenoma is typically found at the site of the original adenoma, repeat transsphenoidal surgery is recommended including selective adenomectomy, hemihypophysectomy or total hypophysectomy. If repeat pituitary surgery does not achieve remission, then possible adjuvant therapies include radiosurgery or stereotactic radiotherapy, bilateral adrenalectomy, and/or medical therapy. In all cases of persistent or recurrent CD, successful treatment requires close collaboration of endocrinologists, radiation oncologists and neurosurgeons.
经蝶窦选择性腺瘤切除术通常被推荐用于库欣病（CD）的初始治疗，因为它能达到较高的缓解率（70-85%）。然而，如果初始手术不成功，那么持续性或复发性 CD 的治疗方法就更为复杂。因为残留或复发性腺瘤通常位于原来腺瘤的部位，因此建议再次进行经蝶窦手术，包括选择性腺瘤切除术、半垂体切除术或全垂体切除术。如果重复垂体手术不能缓解疾病，则可能的辅助治疗包括放射外科手术或立体定向放射治疗、双侧肾上腺切除术和/或药物治疗。在所有持续性或复发性 CD 的情况下，成功的治疗需要内分泌学家、放射肿瘤学家和神经外科医生的密切合作。
