Gupta Prakamya, Tripathi Manjul, Dhandapani Sivashanmugam, Dutta Pinaki
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh; Division of Innovation and Translational Research, Indian Council of Medical Research, New Delhi, India.
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Neurol India. 2020 Sep-Oct;68(5):1183-1187. doi: 10.4103/0028-3886.299156.
Although low-and middle-income countries (LMIC) bear the burden of the pituitary adenomas, most research is conducted in developed countries. However, there has been significant growth in research on pituitary adenomas in India from 1995 to 2020. The cost of patient treatment, management, and surgery of pituitary lesions are comparatively lower in India in comparison to high income countries.
The intended goal is to highlight the current scenario of pituitary research in India with regards to prevalence/incidence, tumor size, treatment modalities, cost of pituitary surgery, and potential strategies for tackling pituitary adenoma disease burden in the country.
In addition to the literature review, recommendations were included from neurosurgeons, endocrinologists, and radiologists from various centers in India.
There is an increasing evidence of pituitary adenoma heterogeneity compared to western populations. Although there has been significant increase in research on pituitary tumors from India, it is considerably less as compared to the data from the rest of the world. The major challenges for the treatment of this benign disease in India are lack of imaging facility in rural areas, poor patient follow up, and financial constraints for periodic imaging and biochemical assessment.
A computerized pituitary registry and genetic screening and testing will significantly boost research and lead to better patient outcome in the country. Special emphasis should be laid on multimodal management to ascertain optimal long-term tumor control with best hormonal outcome.
尽管低收入和中等收入国家(LMIC)承担着垂体腺瘤的负担,但大多数研究是在发达国家进行的。然而,1995年至2020年期间,印度对垂体腺瘤的研究有了显著增长。与高收入国家相比,印度垂体病变患者的治疗、管理和手术成本相对较低。
旨在突出印度垂体研究的现状,包括患病率/发病率、肿瘤大小、治疗方式、垂体手术成本以及应对该国垂体腺瘤疾病负担的潜在策略。
除了文献综述外,还纳入了印度各中心神经外科医生、内分泌学家和放射科医生的建议。
与西方人群相比,垂体腺瘤异质性的证据越来越多。尽管印度对垂体肿瘤的研究有了显著增加,但与世界其他地区的数据相比仍少得多。在印度治疗这种良性疾病的主要挑战是农村地区缺乏成像设施、患者随访不佳以及定期成像和生化评估的经济限制。
计算机化的垂体登记以及基因筛查和检测将显著促进该国的研究并带来更好的患者预后。应特别强调多模式管理,以确定最佳的长期肿瘤控制并获得最佳的激素治疗效果。