国际神经病学神经外科学杂志2025，Vol.52Issue(2)：72-80,9.DOI:10.16636/j.cnki.jinn.1673-2642.2025.02.012
生长激素分泌型垂体神经内分泌肿瘤治疗的现状与新进展
Current status and new advances in treatment of growth hormone-secreting pituitary neuroendocrine tumors
贺诗涵 1刘志雄1
作者信息
- 1. 中南大学湘雅医院神经肿瘤专科,湖南 长沙 410008
- 折叠
摘要
Abstract
Growth hormone-secreting pituitary neuroendocrine tumor(GH-PitNET)are a group of anterior pituitary neoplasms characterized by excessive secretion of growth hormone(GH).The latest consensus statements point out that biochemical remission in such tumor patients is defined as a random GH level of<1 μg/L and the reduction in serum insulin-like growth factor-1 to the range adjusted for age and sex.In order to achieve the above treatment goals,the application of new surgeries,drugs,and radiotherapy regimens in recent years has effectively improved tumor control rate.Neuroendoscopic endonasal transsphenoidal surgery has gradually replaced traditional microscopic procedures due to its superior visualization and illumination capabilities,and intraoperative pseudocapsule-based extracapsular resection and selective resection of cavernous sinus medial wall have further improved the total resection rate of tumor.For patients who are unsuitable for surgery or fail to achieve hormonal remission after surgery,oral administration of somatostatin receptor ligands and the development of the new drug Paltusotine can improve the compliance of patients,and combined treatment with multiple drugs can improve hormone control rate.In addition,bevacizumab and immune checkpoint inhibitors may become new options for pituitary neuroendocrine tumors refractory to temozolomide.Stereotactic radiotherapy has the advantages of high accuracy and low dose and has become the main radiotherapy regimen for GH-PitNET at present,and its efficacy has been confirmed in clinical practice.For residual tumor tissue near the optic nerves,fractionated radiotherapy can effectively reduce the incidence rate of optic nerve damage,without affecting treatment outcome.This article reviews the current status and new advances in the treatment of GH-PitNETs.关键词
生长激素/肢端肥大症/垂体神经内分泌肿瘤/手术/药物治疗/放疗/伽玛刀/鞍区肿瘤/神经内镜Key words
growth hormone/acromegaly/pituitary neuroendocrine tumor/surgical treatment/pharmacotherapy/radiotherapy/gamma knife/sellar tumor/neuroendoscopy分类
医药卫生引用本文复制引用
贺诗涵,刘志雄..生长激素分泌型垂体神经内分泌肿瘤治疗的现状与新进展[J].国际神经病学神经外科学杂志,2025,52(2):72-80,9.
