伽玛刀治疗术后残留无功能性垂体瘤的远期效果分析

摘要

目的：评价伽玛刀治疗术后残留无功能性垂体腺瘤的远期疗效及相关并发症。方法回顾性分析2004年1月至2014年12月期间，在我院接受伽玛刀治疗的284例术后残留无功能性垂体腺瘤患者的临床资料。根据伽玛刀治疗时机分为早期治疗组（术后6月以内）172例及晚期治疗组（术后6月以后）112例。伽玛刀治疗中心剂量12～40 Gy，平均23.68 Gy，周边剂量6～20 Gy，平均11.75 Gy。术后定期复查鞍区MRI和血液激素水平，对复查结果进行对比分析。结果两组患者治疗后肿瘤体积均较治疗前缩小，差异有统计学意义（ P＜0.01）。本组总的肿瘤控制有效率为96.47％，早期治疗组肿瘤控制有效率高于晚期治疗组（ P＜0.05）。伽玛刀治疗后新发垂体功能低下发生率为2.46％，治疗后无视力视野障碍加重病例。结论术后早期伽玛刀治疗能有效控制术后残留无功能性垂体腺瘤的生长，是治疗术后残留垂体腺瘤的安全有效的重要手段。%Objective To evaluate the long-term effectiveness and complications of gamma knife surgery for treating residual nonfunctional pituitary adenomas after surgical debulking .Methods A retrospective analysis of clinical data of 284 cases was per-formed.The patients with residual nonfunctional pituitary adenomas underwent surgery followed by gamma knife radio -surgery between January 2004 and December 2014 .The patients were treated with center doses of 12~40 Gy ( average =23.68 Gy) and peripheral do-ses of 6~20 Gy ( average =11.75 Gy) .Saddle area MRI and blood hormones were regularly reexamined after surgery .The data were comparatively analyzed .Results The tumor volume of the two groups was reduced after Gamma Knife radio-surgery ( P<0.01 ) .The total effective rate of tumor control was 96.7%.The effective rate in patients with early treatment was higher than that in patients with later treatment (P<0.05).Pituitary hypofunction occurred in 2.46%patients after the Gamma Knife radio-surgery.No patient experi-enced of poor eyesight and visual field after surgery .Conclusion Early Gamma Knife radio-surgery can effectively control tumor growth and is a safe and effective treatment for residual nonfunctional pituitary adenomas after surgery .