Bir Shyamal C, Murray Richard D, Ambekar Sudheer, Bollam Papireddy, Nanda Anil
Department of Neurosurgery, LSU Health-Shreveport, Shreveport, Louisiana, United States.
J Neurol Surg B Skull Base. 2015 Sep;76(5):351-7. doi: 10.1055/s-0035-1549309. Epub 2015 May 8.
Objective To elucidate the role of Gamma Knife radiosurgery (GKRS) in the management of nonfunctioning pituitary adenomas (NFAs). Materials and Methods A retrospective review of 57 consecutive patients spanning 2000 to 2013 with NFAs was performed. Of 57 patients, 53 patients had recurrent or residual tumors after microsurgical resection. The study population was evaluated clinically and radiographically after GKRS treatment. The median follow-up time was 45.57 months. Results GKRS in pituitary adenomas showed significant variations in tumor growth control (decreased in 32 patients [56.1%], arrested growth in 21 patients [36.1%], and increased tumor size in 4 patients [7%]). Progression-free survival after GKRS at 3, 7, and 10 years was 100%, 98%, and 90%, respectively. The neurologic signs and symptoms were significantly improved after GKRS (14% versus 107%) compared with pretreated signs and symptoms (p < 0.0001). Five patients (8.8%) required additional treatment. Conclusion Recent follow-up revealed that GKRS offers a high rate of tumor control and preservation of neurologic functions in both new and recurrent patients with NFAs. Thus GKRS is an effective treatment option for recurrent and residual as well as newly diagnosed patients with NFAs.
阐明伽玛刀放射外科治疗(GKRS)在无功能垂体腺瘤(NFAs)治疗中的作用。材料与方法:对2000年至2013年连续收治的57例NFAs患者进行回顾性研究。57例患者中,53例在显微手术切除后有复发或残留肿瘤。对研究人群在GKRS治疗后进行临床和影像学评估。中位随访时间为45.57个月。结果:垂体腺瘤GKRS治疗后的肿瘤生长控制情况存在显著差异(32例患者[56.1%]肿瘤缩小,21例患者[36.1%]生长停滞,4例患者[7%]肿瘤增大)。GKRS治疗后3年、7年和10年的无进展生存率分别为100%、98%和90%。与治疗前相比,GKRS治疗后神经体征和症状有显著改善(14%对107%)(p < 0.0001)。5例患者(8.8%)需要额外治疗。结论:近期随访显示,GKRS在新发病例和复发的NFAs患者中均能实现较高的肿瘤控制率并保留神经功能。因此,GKRS是复发和残留以及新诊断的NFAs患者的有效治疗选择。