Thorén M, Rähn T, Hallengren B, Kaad P H, Nilsson K O, Ravn H, Ritzén M, Petersen K E, Aarskog D
Acta Paediatr Scand. 1986 May;75(3):388-95. doi: 10.1111/j.1651-2227.1986.tb10219.x.
Eight children with Cushing's disease aged 6-18 years were treated with external radiation to the pituitary gland using 60Co gamma radiation given with stereotactic technique. The dose given varied between 50 and 70 Gy. The observation time was 2.6 to 6.75 years. Seven children had a clinical remission with normal urinary cortisol excretion. One child had insufficient effect of two irradiations and underwent bilateral adrenalectomy. In the patients in remission the growth velocity increased during the first year after treatment but growth retardation occurred again during the second year. Insufficient growth hormone secretion was demonstrated in all subjects. Two patients were given thyroxine substitution and three showed evidence for secondary hypogonadism. In conclusion, stereotactic pituitary irradiation was effective in normalizing the excessive glucocorticoid production in children with Cushing's disease. However, with the doses used, it was not possible to maintain a normal anterior pituitary function.
8名年龄在6至18岁的库欣病患儿接受了垂体外部放射治疗，采用立体定向技术给予60钴γ射线照射。给予的剂量在50至70 Gy之间。观察时间为2.6至6.75年。7名儿童临床缓解，尿皮质醇排泄正常。1名儿童两次照射效果不佳，接受了双侧肾上腺切除术。缓解的患者在治疗后的第一年生长速度加快，但在第二年又出现生长迟缓。所有受试者均显示生长激素分泌不足。2名患者接受了甲状腺素替代治疗，3名患者有继发性性腺功能减退的证据。总之，立体定向垂体照射对于使库欣病患儿过度的糖皮质激素分泌正常化是有效的。然而，就所使用的剂量而言，无法维持正常的垂体前叶功能。
