Feek C M, McLelland J, Seth J, Toft A D, Irvine W J, Padfield P L, Edwards C R
Clin Endocrinol (Oxf). 1984 Apr;20(4):401-8. doi: 10.1111/j.1365-2265.1984.tb03435.x.
Forty-six patients with GH-secreting pituitary tumours were treated with conventional external pituitary irradiation through two opposed fields to a total dose of 3750 cGy over 15 fractions. Thirty-patients received external radiotherapy as primary treatment and 16 received radiotherapy combined with pituitary surgery. The mean (+/- SD) serum GH in the former group was 74.3 +/- 74.8 mU/l before treatment, falling by 28% per year over 0-5 years and by 16% per year over 0-20 years. The mean (+/- SD) serum GH in the latter group was 265.4 +/- 209.3 mU/l before treatment, falling by 76% in the first year--a direct result of surgical removal of tumour--then by 30% per year over 1-5 years and 16% per year over 1-20 years. Progressive failure of normal anterior pituitary function developed by 10 years, with variable loss of gonadotrophin, corticotrophin and thyrotrophin function. The respective figures for patients treated with radiotherapy alone were 47.4, 29.6 and 16.0% and for the combined group were 70.2, 53.9 and 38.1%. Whilst external pituitary irradiation appears to reduce serum GH concentrations in patients with GH-secreting pituitary tumours the major disadvantages of this form of treatment are the time taken to achieve a cure and the high incidence of hypopituitarism. Nevertheless there did not appear to be any other serious side effects.
46例生长激素分泌型垂体瘤患者接受了常规垂体外部照射，通过两个相对野照射，15次分割的总剂量为3750 cGy。30例患者接受外照射放疗作为初始治疗，16例患者接受放疗联合垂体手术。前一组治疗前血清生长激素平均（±标准差）为74.3±74.8 mU/l，在0至5年期间每年下降28%，在0至20年期间每年下降16%。后一组治疗前血清生长激素平均（±标准差）为265.4±209.3 mU/l，第一年下降76%——这是肿瘤手术切除的直接结果——然后在1至5年期间每年下降30%，在1至20年期间每年下降16%。到10年时出现了正常垂体前叶功能的进行性衰竭，促性腺激素、促肾上腺皮质激素和促甲状腺激素功能有不同程度的丧失。单纯接受放疗患者的相应比例分别为47.4%、29.6%和16.0%，联合治疗组分别为70.2%、53.9%和38.1%。虽然垂体外部照射似乎能降低生长激素分泌型垂体瘤患者的血清生长激素浓度，但这种治疗方式的主要缺点是达到治愈所需的时间以及垂体功能减退的高发生率。然而，似乎没有其他严重的副作用。
