Neggers S J C M M, van der Lely A J
Section of Endocrinology, Department of Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Section of Endocrinology, Department of Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Handb Clin Neurol. 2014;124:303-16. doi: 10.1016/B978-0-444-59602-4.00020-4.
Transsphenoidal surgery and medical treatment are the cornerstones of the management of pituitary adenomas. However, the optimal therapy should be chosen based on the type of tumor, the patient, and the tumor characteristics. For nonfunctional adenomas surgery is still the first-line treatment. However, for prolactinomas surgery has been replaced by medical treatment. In the other functional pituitary adenomas a more balanced approach is needed to decide between surgery and medical therapy as first-line treatment. In the majority of cases a combination of treatment modalities is needed. In acromegaly and TSH-secreting adenomas medical treatment has a more prominent role than in Cushing's disease. In this chapter the efficacy and side-effects of the different medical therapies is discussed according to adenoma type.
经蝶窦手术和药物治疗是垂体腺瘤治疗的基石。然而，应根据肿瘤类型、患者情况和肿瘤特征选择最佳治疗方法。对于无功能腺瘤，手术仍是一线治疗方法。然而，对于催乳素瘤，药物治疗已取代手术治疗。在其他功能性垂体腺瘤中，需要一种更平衡的方法来决定手术和药物治疗作为一线治疗方法的选择。在大多数情况下，需要联合使用多种治疗方式。在肢端肥大症和促甲状腺激素分泌型腺瘤中，药物治疗比在库欣病中发挥更突出的作用。在本章中，将根据腺瘤类型讨论不同药物治疗的疗效和副作用。
