Ziu Mateo, Dunn Ian F, Hess Christopher, Fleseriu Maria, Bodach Mary E, Tumialan Luis M, Oyesiku Nelson M, Patel Kunal S, Wang Renzhi, Carter Bob S, Chen James Y, Chen Clark C, Patil Chirag G, Litvack Zachary, Zada Gabriel, Aghi Manish K
‡Department of Neurosurgery, Seton Brain and Spine Institute, Austin, Texas; §Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts; ¶Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California; ‖Departments of Medicine and Neurological Surgery, Oregon Health Science University, Portland, Oregon; #Guidelines Department, Congress of Neurological Surgeons, Schaumburg, Illinois; **Barrow Neurological Institute, Phoenix, Arizona; ‡‡Department of Neurosurgery, Emory University, Atlanta, Georgia; §§Center for Theoretical and Applied Neuro-Oncology, Department of Neuro-Oncology, University of California, San Diego, San Diego, California; ¶¶Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China; ‖‖Department of Radiology, UC San Diego Health System, University of California, San Diego, San Diego, California; ##Department of Radiology, San Diego Veterans Administration Health System, San Diego, California; ***Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California; ‡‡‡Department of Neurosurgery, George Washington University, Washington, DC; §§§Department of Neurological Surgery, University of Southern California, Los Angeles, California; ‖‖‖Department of Neurosurgery, University of California, San Francisco, California.
Neurosurgery. 2016 Oct;79(4):E541-3. doi: 10.1227/NEU.0000000000001392.
Nonfunctioning pituitary adenomas (NFPAs) are the most frequent pituitary tumors. Due to the lack of hormonal hypersecretion, posttreatment follow-up evaluation of NFPAs is challenging.
To create evidence-based guidelines in an attempt to formulate guidance for posttreatment follow-up in a consistent, rigorous, and cost-effective way.
An extensive literature search was performed. Only clinical articles describing postoperative follow-up of adult patients with NFPAs were included. To ascertain the class of evidence for the posttreatment follow-ups, the authors used the Clinical Assessment evidence-based classification.
Twenty-three studies met the inclusion criteria with respect to answering the questions on the posttreatment radiologic, endocrinologic, and ophthalmologic follow-up. Through this search, the authors formulated evidence-based guidelines for radiologic, endocrinologic, and ophthalmologic follow-up after surgical and/or radiation treatment.
Long-term radiologic, endocrinologic, and ophthalmologic surveillance monitoring after surgical and/or radiation therapy treatment of NFPAs to evaluate for tumor recurrence or regrowth, as well as pituitary and visual status, is recommended. There is insufficient evidence to make a recommendation on the duration of time of surveillance and its frequency. It is recommended that the first radiologic study to evaluate the extent of resection of the NFPA be performed ≥3 months after surgical intervention. The full guidelines document for this chapter can be located at https://www.cns.org/guidelines/guidelines-management-patients-non-functioning-pituitary-adenomas/Chapter_8.
NFPA, nonfunctioning pituitary adenoma.
无功能垂体腺瘤（NFPAs）是最常见的垂体肿瘤。由于缺乏激素分泌过多的情况，NFPAs治疗后的随访评估具有挑战性。
制定基于证据的指南，试图以一致、严谨且具有成本效益的方式为治疗后随访制定指导原则。
进行了广泛的文献检索。仅纳入描述成年NFPAs患者术后随访的临床文章。为确定治疗后随访的证据类别，作者采用了基于临床评估的证据分类法。
23项研究符合纳入标准，回答了关于治疗后放射学、内分泌学和眼科随访的问题。通过此次检索，作者制定了手术和/或放射治疗后放射学、内分泌学和眼科随访的基于证据的指南。
建议对NFPAs进行手术和/或放射治疗后进行长期的放射学、内分泌学和眼科监测，以评估肿瘤复发或生长情况以及垂体和视力状态。关于监测的持续时间及其频率，证据不足，无法给出推荐。建议在手术干预后≥3个月进行首次评估NFPA切除范围的放射学检查。本章的完整指南文件可在https://www.cns.org/guidelines/guidelines-management-patients-non-functioning-pituitary-adenomas/Chapter_8获取。
NFPA，无功能垂体腺瘤
