Li Yanli, Huang Minyi, Liang Shunyao, Peng Chao, Li Xi, Zeng Jiamin, He Yong, Li Wangen, Deng Yinhui, Yu Jinxiu
Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland).
Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China (mainland).
Med Sci Monit. 2020 Sep 23;26:e924884. doi: 10.12659/MSM.924884.
BACKGROUND The aim of this study was to review outcomes of gamma knife radiosurgery (GKRS) for prolactinoma and report our experience with it. MATERIAL AND METHODS We reviewed the patient database in our center and identified 24 patients with prolactinoma who underwent GKRS from 1993 to 2016. Complete endocrine, clinical, and radiological data were available on these individuals before and after GKRS. RESULTS Data from 5 males and 19 females with a median age of 30.5 years (range, 18.1 to 51.1) were reviewed. The median follow-up was 109.3 months (range, 23.2-269.3). The median margin dose of GKRS was 15 Gy (range, 10.5 to 23.6). In total, prolactin (PRL) normalization after GKRS was achieved in 66.7% of patients. Endocrine remission (normal PRL levels after discontinuation of dopamine agonists) was achieved in 10 patients (41.7%), and endocrine control (normal PRL levels while taking dopamine agonists) was achieved in 6 patients (25.0%). All of the patients showed tumor control. New-onset hypopituitarism post-GKRS occurred in 4 patients (16.7%). No new visual dysfunction or cranial nerve dysfunction were observed after GKRS. CONCLUSIONS For treatment of prolactinomas, GKRS may provide relatively high rates of endocrine remission and tumor control, as well as a low rate of new-onset hypopituitarism. GKRS may be an effective and safe treatment for prolactinomas.
背景 本研究的目的是回顾泌乳素瘤的伽玛刀放射外科治疗（GKRS）结果并报告我们的相关经验。
材料与方法 我们回顾了本中心的患者数据库，确定了1993年至2016年期间接受GKRS治疗的24例泌乳素瘤患者。这些个体在GKRS治疗前后均有完整的内分泌、临床和放射学数据。
结果 对5例男性和19例女性的数据进行了回顾，中位年龄为30.5岁（范围18.1至51.1岁）。中位随访时间为109.3个月（范围23.2 - 269.3个月）。GKRS的中位边缘剂量为15 Gy（范围10.5至23.6）。总共有66.7%的患者在GKRS治疗后泌乳素（PRL）恢复正常。10例患者（41.7%）实现了内分泌缓解（停用多巴胺激动剂后PRL水平正常），6例患者（25.0%）实现了内分泌控制（服用多巴胺激动剂时PRL水平正常）。所有患者均实现了肿瘤控制。4例患者（16.7%）在GKRS治疗后出现了新发垂体功能减退。GKRS治疗后未观察到新的视力障碍或颅神经功能障碍。
结论 对于泌乳素瘤的治疗，GKRS可能提供相对较高的内分泌缓解率和肿瘤控制率，以及较低的新发垂体功能减退率。GKRS可能是一种治疗泌乳素瘤的有效且安全的方法。
