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目的评估伽玛刀立体定向放射治疗对垂体腺瘤的治疗效果。方法对２９２例垂体腺瘤患者，用１．５Ｔ磁共振和γｐｌａｎ计算机联网定位，Ｌｅｋｓｅｌ伽玛刀实施放射外科手术。肿瘤直径３．８～５１．１ｍｍ，平均１６．３ｍｍ，照射剂量９～３５Ｇｙ，平均２１．６Ｇｙ。结果本组病例随访１２～３４个月，平均２１个月，获随访２０４例。肿瘤消失３９例（１９．１％），缩小１５６例（７６．４％）；激素值恢复正常１４例（１１．８％），较术前下降９４例（７９．６％）；临床症状改善１９０例（９３．１％），９例症状加重，３例肿瘤增大，２例开颅手术，１例死亡。结论伽玛刀是治疗垂体腺瘤安全、有效的一种方法，但要严格掌握适应证，对Ⅲ级以上肿瘤应首选手术治疗，γ刀治疗后有可能加重垂体低功能状态，诱发垂体危象。
Objective To evaluate the therapeutic effect of gamma knife radiotherapy on pituitary adenoma. Methods 292 cases of pituitary adenoma patients with 1.5T magnetic resonance and γ plan computer network positioning, Leksel gamma knife radiosurgery. Tumor diameter 3.8 ~ 51.1mm, an average of 16.3mm, radiation dose 9 ~ 35Gy, an average of 21.6Gy. Results The patients were followed up for 12 to 34 months, an average of 21 months, were followed up 204 cases. The tumor disappeared in 39 cases (19.1%) and decreased in 156 cases (76.4%). The hormones returned to normal in 14 cases (11.8%), 94 cases (79.6% In 190 cases (93.1%), 9 patients had aggravated symptoms, 3 patients had tumor enlargement, 2 patients had craniotomy, and 1 patient died. Conclusion Gamma knife is a safe and effective method for the treatment of pituitary adenoma. However, strict indications are needed. Surgical treatment of tumors with grade Ⅲ or higher should be the first choice. Gamma knife treatment may aggravate hypopituitarism and induce pituitary crisis .