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目的探讨采用CT与MRI图像融合治疗计划,适形放疗治疗垂体瘤术后残存病例的方法及疗效。方法人23例,男性10例,女性13例;中位45.5岁;23例患者均采用经蝶窦入路外科切除垂体腺瘤术后残存病例,采用CT与MRI融合图像勾画靶区及制作治疗计划。根据MRI及CT重建,残存肿瘤体积GTV2.9～23.8cm3,平均体积12.5cm3。所有病例均采用三维适形放疗DT48～50.6GY。放疗后定期复查视力、肿瘤体积、内分泌激素水平的测定。结果随访25～64个月,肿瘤均得到控制,以肿瘤体积为标准,其中肿瘤体积缩小13例,无变化10例,未出现体积增大病例,治疗后平均体积为10.2cm3。所有病例均未出现失明、脑损伤等放射性反应。术后内分泌激素水平高者均降到正常水平以下。结论采用CT/MRI图像融合适形放疗经鼻蝶窦切除垂体瘤术后残存病例疗效较好,放射性损伤小,值得临床推广。
Objective To explore the method and efficacy of CT and MRI fusion imaging and conformal radiotherapy for residual cases after pituitary tumor surgery. Methods Twenty-three patients were male, 10 were female, and 13 were female. The median was 45.5 years. Surgical resection of pituitary adenoma was performed in all 23 patients. Surgical resection of the pituitary adenoma was performed using CT and MRI. plan. According to MRI and CT reconstruction, the residual tumor volume GTV 2.9 ~ 23.8cm3, the average volume of 12.5cm3. All cases were using three-dimensional conformal radiotherapy DT48 ~ 50.6GY. Regular review of visual acuity after radiotherapy, tumor volume, determination of endocrine hormone levels. Results Twenty-four to 64-month follow-up showed that the tumors were all controlled. Tumor volume was the standard. Tumor volume was reduced in 13 cases, no change in 10 cases, no increase in volume. The average volume after treatment was 10.2 cm 3. No cases of blindness, brain injury and other radioactive reactions. Postoperative high levels of endocrine hormones fell below the normal level. Conclusion CT / MRI image fusion conformal radiotherapy via nasal sphenoid resection of pituitary tumor residual cases of better efficacy, less radioactive damage, is worth clinical promotion.