Treatment Analysis Of Surgery And Rotaing Gamma System Radiosurgery In Pituitary Microadenomas

Objective: Nowdays, treatment of pituitary microadenomas is still in argument. Means as chemotherapy, surgery and radiosurgery (rotaing gamma knife is the mian) are used. Effect of chemothrapy on pituitary PRL microadenomas is confirmed, and effect on other pituitary microadenomas is less betterthan surgery and radiosurgery. In our paper, we discussed the difference between treatment of surgery and rotaing gamma system radiosurgery in pituitary microadenomas.Methods: 52 cases of pituitary microadenomas confirmed by MRI were selected and 25 cases were treated with surgery while others were treated with rotaing gamma system radiosurgery. All the cases were divided into pituitary PRL microadenomas, pituitary ACTH microadenomas, pituitary GH microadenomas and nonfunctioning pituitary microadenomas according to clinical representation and incretionary test. Then were resected with surgery through transnasal transsphenoidal approach or treated with rotaing gamma system radiosurgery in different dose according to tumor classification. Clinical representation, incretionary test, recovery time, imaging examination and complications were include in folloe-up analysis. All statistical analyses were undertaken using SPSS10.0 for Windows. The significance of differences between means was evaluated byχ2 test. Probability values P 0.05 were considered statistically significant.Result:1. improvement of incretion and symptoms: Incretion and symptoms of 19 cases (76.0%) in surgery group were improved. Improvement of incretion and symptoms were also found in 23 cases (85.2%) treated with rotaing gamma system radiosurgery, while 9 cases (33.3%) were needed accessorialchemotherapy.2. recovery time: Recovery time of surgery group were from 2 weeks to 1 month with average 20.3 days. That of gamma system radiosurgery group were from 2 months to 4 months and average was 5.1 months.3. imaging examination: The tumor had vanished in 15 cases (60.0%) of surgery group, and reduced in 10 cases (40.0%) wihtout surgery failure. The tumor had vanished in 11 cases (40.7%) of gamma system radiosurgery group, and reduced in 10 cases (37%). Besides, centric necrosis occurred in 5 cases (18.5%) and clinical failure of the treatment occurred in only 1 patients (3.7%).4. complications: Complications occurred in 3 cases of surgery group. Cerebrispinal fliud rhinorrhea occurred in 2 cases and were cured by symptomatic treatment such as continuous lumbar spinal fluid drainage. One patient dided of postoperative intracranial infection. Reactive intracerebral hemorrhage occurred in 2 cases of gamma system radiosurgery group and improved with treatment of hormone and dehydrant. Hypothyroidism occurred in 1cases and with no death.Conclusion: There were no significance differences between two groups (p>0.05). There treatment effect of gamma system radiosurgery group was higher than that of surgery group, but the improvement time of incretion was longer than that of surgery group and some patients also needed accessorial chemotherapy.