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目的探讨X-刀治疗垂体腺瘤的临床价值。方法采用德国BrainScanX刀治疗系统治疗了垂体腺瘤病人35例,肿瘤周边剂量平均为12.32Gy,视神经和视交叉的最大照射剂量小于8~10Gy,治疗后每三个月随访一次CT和激素检查,所有病例随访时间均1年以上。结果肢端肥大症表现减轻占75%(9/12);泌乳停止者占68.75%(11/16),头痛减轻占87.5%(14/16)。肿瘤消失和缩小的病人占74.29%,过度分泌的激素有明显下降,部分病人已接近正常,无发生放射性视神经损害;病理发现垂体腺瘤细胞对高剂量射线照射较为敏感。结论X刀是治疗垂体腺瘤安全、可靠和有效的重要手段之一。
Objective To investigate the clinical value of X-knife treatment of pituitary adenoma. Methods Thirty-five patients with pituitary adenoma were treated with the German BrainScanX knife treatment system. The average tumor dose was 12.32 Gy. The maximum irradiation dose of the optic nerve and optic chiasm was less than 8-10 Gy. CT and hormonal examinations were performed every three months after treatment. All cases were followed up for more than 1 year. Results The acromegalic performance was reduced by 75% (9/12); the lactation stoppage was 68.75% (11/16), and the headache reduction was 87.5% (14/16). 74.29% of patients with disappeared and shrinked tumors had excessive secretion of hormones. Some patients were close to normal and no radiation-induced optic nerve damage occurred. Pathologically, pituitary adenoma cells were sensitive to high dose radiation. Conclusion X-knife is one of the important methods to treat pituitary adenomas safely, reliably and effectively.