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目的 分析报告微小垂体腺瘤 SRS治疗观察结果。方法 94年 8月至 98年 8月对1 8例经挑选的垂体瘤实施了 SRS治疗。中位肿瘤最大直径为 1 0 mm,中位年龄 34岁 ,中位肿瘤边缘剂量 2 0 Gy。结果 87.5% (1 4/1 6)的病例获得临床症状改善 ,1 2 .5% (2 /1 6)无变化。影象学观察结果显示 37.5% (6/1 6)肿瘤缩小 ;56.3% (9/1 6)肿瘤体积无变化。 2 1 .4% (3/1 4)激素水平在 SRS治疗后 1年降至正常 ,57.1 % (8/1 4)激素水平有所下降 ,2 1 .4% (3/1 4)未变。结论 肿瘤周边剂量1 8～ 2 2 Gy为安全有效的治疗剂量。建议谨慎掌握对年轻病人 SRS剂量 ,对体积较大、有明显侵袭性、紧贴视神经的垂体瘤应以显微外科或者立体定向分次照射为首选治疗手段。
Objective To analyze the results of SRS treatment of tiny pituitary adenomas. Methods From August 1994 to August 1998, 18 patients with selected pituitary adenomas underwent SRS. The median tumor diameter was 10 mm, the median age was 34 years and the median tumor margin dose was 20 Gy. Results The clinical symptoms were improved in 87.5% (14/1 6) cases and no change in 12.5% (2/16). Imaging findings showed that 37.5% (6/1 6) tumors were reduced; 56.3% (9/1 6) tumors did not change. Hormone levels decreased to normal one year after SRS treatment, with a decrease of 57.1% (8/1 4) hormone levels, and 21.4% (3/14) of the same . Conclusion The peripheral dose of 18 ~ 22 Gy is a safe and effective therapeutic dose. Proposed careful control of the dose of SRS in young patients, for larger, significantly invasive, close to the optic nerve pituitary tumor should be microsurgery or stereotactic fractionated irradiation is the preferred treatment.