The Therapeutic Efficacy On Visual Functions Of Pituitary Adenomas With Gamma Knife: Analyze Factors Associated With Prognosis

Objective:To evaluate the therapeutic efficacy of gamma knife radiosurgery (GKS) on visual functions of pituitary adenomas and to investigate the correlative factors that might influence the effect.Methods:The clinical dates of 116 cases which collected from three different gamma knife research centers were retrospectively analyzed the effects and complications.45cases had previous transsphenoidal or transcranial surgery prior to GKS. The gamma knife radiosurgery was the primary treatment for 71 patients..Inaddition to this.89 patients received MRI examination. Each tumor was assessed with visual acuity, visual field examination,pituitary function and magnetic resonance imaging scans at intervals after radiosurgery. The visual level before gamma knife, peripheral dose, tumor size,pathological types,, the sex and age were statistically analyzed to find the correlation to effect.Results:1 The number of patients had visual dysfunctions before gamma knife treatment were 76. Using single factor analysis (chi-square statistics), the visual dysfunctions before GKS were hightly associated with tumor size,had surgery treatment or not,age;and had no association with sex/pathological types. logistic analysis proved the tumor size, age were dependment factors with visual dysfunctions before GKS.2 The databases of patients followed up for a median of 61.5 month after the radiosurgery. Forty-six patients had visual recovery, the cure rate was 47.1%.45 patients had part-recovery (59.4%), Eighty-four cases'tumor volumes decreased, the effective control rate was72%.3 Different peripheral dose applied prognosis,χ2=8.04,P=0.0018, has statistics significance. Whether the prior-visual>0.5,χ2=11.35,P=0.001,had statistics significance. Different tumor size,χ2=6.24, P=0.028, has statistics significance; whetherhad the cavernous sinus infiltration or not,χ2=7.94,P=0.005, has statistics significance. Different agex2=4.09, P=0.03, has statistics significance.Different pathological types. and sex prognosis, P1=0.14, P2=0.07, both have no statistics significance.Conclusions:1. The gamma knife is an effective and safe method for pituitary adenomas.2. The visual dysfunctions before GKS were hightly associated with tumor tumor size, the cavernous sinus infiltration,whether had surgery treatment,age, and had no association with sex and pathological type. 3. The visual dysfunctions before GKS,tumor size, whetherhad the cavernous sinus infiltration,whether had surgery treatment age,peripheral dose,age are important influencing factors to evaluate the prognosis of GKS. Tumor pathological type, sex have not significant correlation to the efficacy.