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连欣, 沈晶, 孙显松, 杨波, 孙玉亮, 沈捷, 张福泉. 15例垂体巨大腺瘤患者调强放射治疗效果分析[J]. 协和医学杂志, 2022, 13(1): 117-123. DOI: 10.12290/xhyxzz.2021-0413
引用本文: 连欣, 沈晶, 孙显松, 杨波, 孙玉亮, 沈捷, 张福泉. 15例垂体巨大腺瘤患者调强放射治疗效果分析[J]. 协和医学杂志, 2022, 13(1): 117-123. DOI: 10.12290/xhyxzz.2021-0413
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LIAN Xin, SHEN Jing, SUN Xiansong, YANG Bo, SUN Yuliang, SHEN Jie, ZHANG Fuquan. Treatment Outcome of Intensity-modulated Radiotherapy for 15 Patients with Giant Pituitary Adenoma[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(1): 117-123. DOI: 10.12290/xhyxzz.2021-0413
Citation: LIAN Xin, SHEN Jing, SUN Xiansong, YANG Bo, SUN Yuliang, SHEN Jie, ZHANG Fuquan. Treatment Outcome of Intensity-modulated Radiotherapy for 15 Patients with Giant Pituitary Adenoma[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(1): 117-123. DOI: 10.12290/xhyxzz.2021-0413
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15例垂体巨大腺瘤患者调强放射治疗效果分析

Treatment Outcome of Intensity-modulated Radiotherapy for 15 Patients with Giant Pituitary Adenoma

    摘要
  • 摘要:
      目的  分析调强放射治疗技术治疗垂体巨大腺瘤的临床实践经验，以期为临床诊疗提供借鉴。
      方法  回顾性分析2012年10月至2018年10月于北京协和医院放射治疗科接受直线加速器6 MV-X线调强放射治疗(56~60 Gy/28~30次，5次/周)的垂体巨大腺瘤患者资料，以肿瘤生长控制率、激素缓解率、放射治疗相关并发症为指标评价患者的治疗效果。
      结果  共15例符合纳入标准的患者入选本研究，其中男性8例，女性7例；中位年龄为32岁。肿瘤生长控制率为93.3%(11例部分缓解，3例肿瘤稳定，1例发展为垂体癌)；7例功能性垂体巨大腺瘤患者中，1例激素水平完全缓解，2例部分缓解。4例患者采用调强放射治疗联合替莫唑胺治疗，均达到肿瘤部分缓解(中位缓解时间为5个月)，缓解率及缓解时间均优于未使用替莫唑胺者。放射治疗后随访期内，4例患者出现新发垂体功能受损，未出现新发或进一步加重的视力减退及视野受损。
      结论  调强放射治疗是垂体巨大腺瘤患者有效的治疗方法，与替莫唑胺联合应用可加快肿瘤体积缩小、缓解占位效应。

     

    Abstract:
      Objective  To summarize the clinical experience of intensity-modulated radiotherapy(IMRT) for patients with giant pituitary adenoma, and to provide evidence for clinical treatment.
      Methods  The data of patients with giant pituitary adenoma who received 6MV-X IMRT with linear accelerator (prescription dose of 56-60 Gy/28-30 fractions, 5 fractions per week) in the Department of Radiation Oncology of Peking Union Medical College Hospital from October 2012 to October 2018 were reviewed. Treatment outcomes were evaluated by the control rate of tumor growth, remission rate of endocrine hormone, and radiation-related complications.
      Results  A total of 15 patients were included in this study. There were 8 males and 7 females with a median age of 32 years. The control rate of tumor growth was 93.3% (partial response in 11 cases, stable in 3 cases, and development of pituitary carcinoma in 1 case). Among the 7 patients with functional giant pituitary adenoma, 1 patient achieved complete remission of the level of endocrine hormone and 2 patients achieved partial remission. Four patients treated with radiotherapy plus temozolomide achieved partial remission (median remission time was 5 months), and the remission rate and remission time were better than those who did not receive temozolomide. During the follow-up period after radiotherapy, 4 patients were found having newly pituitary dysfunction. There were no new or aggravating visional impairment and visual field defects.
      Conclusion  Intensity-modulated radiotherapy is an effective treatment for giant pituitary adenoma, which can reduce the tumor faster combined with temozolomide.

     

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