Pituitary Radiotherapy

Abstract

Pituitary adenomas are usually benign intracranial tumours accounting for about 10 to 15% of all intracranial malignancies. They are managed with a combination of surgery, medical therapy, and radiotherapy to control symptoms related to mass-effect and hypersecretion of hormones. Trans-sphenoidal surgery is the standard initial approach in the majority of patients and provides long-term local and hormonal control in completely excised lesions. Radiotherapy is indicated in progressive residual and recurrent adenomas, or in lesions not amenable for surgery or medical treatment. Radiotherapy achieves local tumour control rates of over 90% in most series. In secreting tumours, hormonal control is attained after radiotherapy in the majority of patients, independent of the secreting tumour subtype. Modern radiotherapy techniques allow the delivery of an effective therapeutic dose to the tumour while permitting a substantial reduction in the amount of dose to the surrounding healthy brain, limiting the risk of treatment-related long-term complications.