Effect of stereotactic radioneurosurgery robot CYBER knife system in the treatment of pituitary adenoma
WEI Pengxiang1,2 ZHANG Hongbo3 WANG Yanming4
1.Department of Neurosurgery, Shunde Hospital Affiliated to Guangzhou Chinese and Western Medicine University, Guangdong Province, Fuoshan 528333, China; 2.Department of Neurosurgery, Dongfang Hospital Affiliated to Beijing Traditional Medical University, Beijing 100078, China;
3.Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, the National Key Clinic Specialty, the Engineering Technology Research Center of Education Ministry of China, the Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangdong Province, Guangzhou 510282, China;
4.Department of Neurosurgery, 960 Hospital of PLA, Shandong Province, Ji′nan 250031, China
Abstract：Objective To explore the approaches to CYBER knife system for stereotactic radiosurgery (SRNS) in the treatment of pituitary adenoma, and to open up a new non-invasive way for the treatment of pituitary adenoma. Methods A total of 12 patients with pituitary tumor Admitted to 960 Hospital of PLA and Affiliated Hospital of Shandong Acodemy of Medical Sciences from May 2015 to Decmber 2018 were selected and treated with CYBER knife system, a fifth-generation non-invasive robot from the United States. 126 radiating nodes were used, and the treatment was divided into three times, with each interval of 24 h and three times of total dose of 20 Gy. The dose of the optic nerve at the edge of the tumor was 20 Gy, combined with the clinical symptoms and endocrine changes, the efficacy of CYBER knife in the treatment of pituitary adenoma was analyzed. Results There were 6 cases of PRL tumor and 6 cases of GH tumor. The tumor diameter was 2.0 - 3.5 cm, with an average (2.30±0.78) cm. The preoperative PRL in 4 patients was significantly higher than 200 ng/L, with an average (390.00±45.32) ng/L, 2 patients increased, with an range value of 37.5 - 68.6 ng/L, and with an average (46.00±17.69) ng/L, GH of 6 patients elevated, and with an average (14.00±9.13) ng/L. MRT2 reexamination 2 weeks after treatment showed tumor radionecrosis. Postoperative reexamination showed that 4 cases of hormone completely returned to normal, 8 cases of neuroendocrine disorder, of which 6 cases returned to normal, 1 case of mild decrease, and 1 case without improvement. The patients were followed up for 3 to 11 months, with an average of 5.8 months. One patient had low endocrine function and received oral prednisone and thyroxine replacement therapy. One case of recurrence was treated by surgery. No permanent diabetes insipidus or death from surgery. Conclusion It is safe and feasible to apply the CYBER knife system of stereotactic non-frame radioneurosurgery to treat pituitary adenoma at a dose of 20 Gy and above 100 nodes.
2019, Vol. 16 
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