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用直线加速器放射科(X刀)治疗16例垂体催乳素瘤。女性15例,男性1例,平均年龄27.5岁。曾用过溴隐亭治疗。采用MRI扫描确定腺癌的大小,CT扫描用于立体定向靶点定位、腺瘤的直径都限于4～10mm,与视交叉的间距为2～5mm。用5或7.5mm准直器,最大剂量20～25Gy。治疗后随访12个月、结果为:7例病人临床症状缓解,PRL恢复至20～25ng/ml;6例获改善,PRL降至40～100ng/ml;3例病人无变化,PRL>200ng/ml。MRI扫描发现11例病人瘤体消失或缩小,5例瘤体直径无变化。治疗前视力、视野正常者未发现治疗后的视觉功能损害,而3例已有视力视野损害的病人有2例治疗后获改善。结果表明,直线加速器放射外科是可供治疗垂体微腺瘤选择的有效而无创的手段。
16 cases of pituitary prolactinoma were treated with linear accelerator radiotherapy (X knife). 15 females, 1 males, with an average age of 27.5 years. Bromocriptine used to be treated. The size of adenocarcinoma was determined by MRI scan. The CT scan was used for stereotactic target location. The diameter of adenoma was limited to 4 ~ 10mm and the distance to optic chiasm was 2 ~ 5mm. With 5 or 7.5mm collimator, the maximum dose of 20 ~ 25Gy. After treatment, the patients were followed up for 12 months. The results showed that the clinical symptoms of 7 patients were relieved, the PRL recovered to 20-25 ng / ml, 6 cases improved, PRL decreased to 40-100 ng / ml, 3 cases had no change, PRL> 200 ng / ml. MRI scan found that 11 patients disappeared or reduced the size of the tumor, 5 cases of tumor diameter did not change. Before treatment, visual acuity and normal vision were not found after treatment of visual impairment, and 3 patients with visual field damage in 2 patients improved after treatment. The results show that the linear accelerator radiosurgery is available for the treatment of pituitary adenoma selection of effective and noninvasive means.