The Therapeutic Efficacy Of Growth Hormone-secreting Pituitary Adenomas: Analyze Factors Associated With Prognosis

Objective: To evaluate the therapeutic efficacy of gamma knife radiosurgery (GKS) for growth hormone-secreting pituitary adenomas and to investigate the correlative factors that might influence the effect.Methods: The clinical dates of 90 cases which collected from three different gamma knife research centers were retrospectively analyzed the effects and complications. 32 cases had previous transsphenoidal or transcranial surgery prior to GKS. The gamma knife radiosurgery was the primary treatment for 58 patients. Each tumor was assessed with serial endocrinological examination, pituitary function and magnetic resonance imaging scans at intervals after radiosurgery. Pituitary suppressive medication administration, preradiosurgery growth hormone (GH) level, peripheral dose, tumor size, the cavernous sinus infiltration, sex and age were statistically analyzed to find the correlation to effect.Results: The databases of patients followed up for a median of 51.5 month after the radiosurgery. Forty-six patients had biochemical remission, the cure rate was 51.1%. The GH levels of seventy-eight cases were less than 5μg/L. The clinical symptoms of them improved obviously after the GH levels' degression. GKS suppressed the growth of GH-secreting pituitary adenomas effectively. Eighty-four cases' tumor volumes decreased, the effective control rate was 93.3%. The incidence of new anterior pituitary deficits was 14.4%. Different peripheral dose applied prognosis, x²=7.13, P=0.008, has statistics significance. Whether administrated the suppressive medication compares, x²=11.49, P=0.001 , has statistics significance. Whether the preradiosurgery GH level less than 50μg/L, x²=11.35, P=0.001, has statistics significance. Whether infiltrated the cavernous sinus prognosis, x²=7.94, P=0.005, has statistics significance. Different tumor size prognosis, x²=4.09, P=0.13, has no statistics significance. Different age and sex prognosis, P₁=0.74, P₂=0.81, both have no statistics significance.Conclusions:1. The gamma knife is an effective method for GH-secreting pituitary adenomas.2. Pituitary suppressive medication administration, preradiosurgery GH level, peripheral dose and the cavernous sinus infiltration are important influencing factors to evaluate the prognosis of GKS.3. However, tumor size, sex and age have not significant correlation to the efficacy.