Department of Radiation Oncology, The Prince of Wales Cancer Centre, Level 2, High Street, Randwick, NSW 2031, Australia; Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia.
Department of Radiation Oncology, The Prince of Wales Cancer Centre, Level 2, High Street, Randwick, NSW 2031, Australia.
J Clin Neurosci. 2014 Jan;21(1):100-6. doi: 10.1016/j.jocn.2013.04.007. Epub 2013 Sep 24.
Cushing's disease is hypercortisolaemia secondary to an adrenocorticotrophic hormone secreting pituitary adenoma. Primary management is almost always surgical, with limited effective medical interventions available. Adjuvant therapy in the form of radiation is gaining popularity, with the bulk of the literature related to the Gamma Knife. We present the results from our own institution using the linear accelerator (LINAC) since 1990. Thirty-six patients who underwent stereotactic radiosurgery (SRS), one patient who underwent fractionated stereotactic radiotherapy (FSRT) and for the purposes of comparison, 13 patients who had undergone conventional radiotherapy prior to 1990, were included in the analysis. Serum cortisol levels improved in nine of 36 (25%) SRS patients and 24 hour urinary free cortisol levels improved in 13 of 36 patients (36.1%). Tumour volume control was excellent in the SRS group with deterioration in only one patient (3%). The patient who underwent FSRT had a highly aggressive tumour refractory to radiation.
库欣病是由于促肾上腺皮质激素分泌垂体腺瘤引起的皮质醇增多症。主要治疗方法几乎总是手术，仅有有限的有效药物治疗干预措施。辅助治疗形式的放射治疗越来越受欢迎，大量文献与伽玛刀有关。我们展示了自 1990 年以来使用线性加速器（LINAC）在我们机构的治疗结果。36 名接受立体定向放射外科（SRS）治疗的患者，1 名接受分割立体定向放射治疗（FSRT）的患者，以及为了比较目的，13 名在 1990 年之前接受常规放射治疗的患者，均纳入分析。36 名 SRS 患者中有 9 名（25%）血清皮质醇水平改善，36 名患者中有 13 名（36.1%）24 小时尿游离皮质醇水平改善。SRS 组肿瘤体积控制非常好，只有 1 名患者（3%）病情恶化。接受 FSRT 的患者肿瘤具有侵袭性，对放射治疗有抗性。
