A. Treatment principle Gamma knife treatment of pituitary tumor is the use of gamma radiation geometric focusing mode, through precise stereotactic, the planned dose of gamma radiation focused on the pre-illumination target, the tumor (pituitary tumor) tissue for multi-field, multi-angle irradiation, and according to the different shapes and sizes of tumors to implement conformal radiotherapy. The treatment volume is basically equal to the volume of the lesion (i.e. “target”), which can lethally destroy the tumor tissue within the target, or through the accumulation of high-energy gamma rays in the tumor target area to form the amount of radiation, gradually reach the lethal member of the tumor tissue, killing the diseased tissue, in order to achieve the effect of surgical removal or destruction of the tumor.
Second, the indications Although the gamma knife treatment of pituitary tumor way to be affirmed, but not all patients are suitable for gamma knife this treatment. For adolescent patients who have not yet had children, pituitary tumor is too large, pituitary adenoma and the distance between the optic cross is too close to the patient is not suitable for gamma knife treatment. So who is suitable for gamma knife treatment?
In fact, the scope of application of Gamma Knife is very wide, for the following patient population is very suitable for the use of Gamma Knife treatment.
1, cavernous sinus or skull base invaded pituitary tumor, postoperative residual recurrence or preferred treatment.
2, drug therapy is ineffective, can not tolerate the side effects of drug therapy or unwilling to surgery patients with pituitary microadenoma.
3.Pituitary adenoma with postoperative residual or recurrence; (pituitary macroadenoma with optic bundle and optic cross spacing >3- 5mm).
4.Patients with pituitary tumors that cannot tolerate surgery due to old age or concomitant medical diseases (such as hypertension, diabetes, heart disease or coagulation disorders, etc.).
Gamma knife” is called “knife”, but in fact is not a real scalpel, it is a hemispherical helmet covered with direct aligners, the helmet can shoot out 201 cobalt 60 high dose ion rays -gamma rays. It is precisely located in a certain area, which we call the “target”, by modern imaging techniques such as CT and MRI. Its positioning is extremely accurate, often less than 0.3 mm error; 201 rays from different locations gathered together can destroy the target tissue, thereby destroying tumor cells.
Gamma knife treatment of pituitary tumors and surgery for pituitary tumors: 1, gamma knife treatment of pituitary tumors is minimally invasive treatment, does not require general anesthesia, no incision, no bleeding and no infection and other advantages, while surgical treatment requires open surgery or even craniotomy, high surgical risk, the patient’s pain is much greater than gamma knife treatment.
2, gamma knife treatment time is short, the process only takes about 2 hours, surgery treatment time depends on the patient’s condition, and after treatment to be hospitalized, hospitalization time is generally about a week.
3, gamma knife treatment cost is low, although the cost varies slightly according to the choice of hospital, doctor and the patient’s situation, but basically in about 20,000 yuan, much lower than the cost of surgery for pituitary tumors.
4, gamma knife treatment pituitary tumor precise and effective, gamma knife belongs to the advanced medical instruments, gamma knife radiation accuracy error can be controlled to 0.3mm, and combined with CT, MRI for precise positioning of pituitary tumor. And the effect of surgical treatment is mostly linked to the experience and technology of the doctor, if the doctor makes a mistake, then the impact on the patient is huge.
Fourth, side effects For gamma knife treatment of pituitary tumors, the complications are much lower than other treatment modalities such as surgery, the common complications are mainly headache, dizziness, nausea, vomiting, pallor, sweating, etc., the incidence is 4-12.6%; radiation reactions are reversible, the disappearance rate is 100%, the disappearance time is usually within 24 hours. What needs to be focused on and dealt with are the distant complications, mainly including damage to the optic pathway, brain nerves in the cavernous sinus, hypothalamus and hypopituitarism, with an incidence of 0-12.6% reported in the literature.