Analysis Of The Changes Of Hormone Levels Between Surgery And Gamma Knife Radiosurgery For Growth Hormone-secreting Pituitary Adenomas

ObjectiveTo explore the changes of growth hormone levels in patients with growth hormone-secreting pituitary adenomas before and after the treatment of surgery and gamma knife radiosurgery. MethodsA retrospective analysis of the total data of 95 patients with growth hormone(GH)-secreting pituitary adenomas that first diagnosed or treated in the neurosurgery department of the Fist Affiliated Hospital of Zhengzhou University from June 2011 to January 2015.61 Patients that treated by surgery alone are classified as surgery group.Which divided into complete group(45 cases)and uncomplete group(16 cases)according to the degree of tumor resection in surgery and imaging data after surgery.34 Patients that treated by gamma knife radiosurgery(GKRS) alone are classified as gamma knife radiosurgery group(OUR-XGD gamma knife). Patients were diagnosed as GH pituitary adenomas according to their clinical symptom,incretionary test and imaging examination.Follow up for 12 months to compare the changes of GH levels at different time points before and after treatment. ResultsThe GH levels first week after surgery in both complete group and uncomplete group were decreased significantly compared with preoperative ones,and the difference was statistically significant(p<0.01).While there was no significant difference between first week and other time points until twelfth month after surgery(p>0.05).And the GH levels in complete group were lower than the uncomplete group in all time points that we were followed up after surgery.The difference was statistically significant(p<0.01).The GH levels were no significant difference between the ones before GKRS and that first month,third month after GKRS(p>0.05).The GH levels sixth month after GKRS were decreased compared with that before GKRS.The difference was statistically significant(p<0.05).And GH levels twelfth month after GKRS were decreased compared with the sixth month after GKRS.The difference was statistically significant(p<0.01).12 month after treatment,the decrease degree of GH levels of GKRS group were lower than surgery group which contents complete group and uncomplete group.The difference was statistically significant(p<0.05). Conclusion1、The higher GH levels of patients with growth hormone-secreting pituitary adenomas can be cut down speedly by surgery,which shows that surgical treatment can achieve better efficacy,and is the first choice of treatment.The GH levels in the first week after surgery can be used as a method to judge the surgery efficacy.The postoperative growth hormone decreased more significantly for complete tumor removal patients,so pituitary adenomas should be completely excised as much as possible without injuring the normal pituitary tissues.2、The GH levels of patients with growth hormone-secreting pituitary adenomas drops slowly after gamma knife radiosurgery,and gradually decreased with time.It can not improve the higer levels of GH quickly.Within 1 year,gamma knife radiosurgery on the melioration of GH levels is worse than surgery.