open access

Vol 21, No 4 (2016)
Special Issue Papers
Published online: 2016-07-01
Submitted: 2014-04-21
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Stereotactic radiotherapy and radiosurgery for non-functioning and secreting pituitary adenomas

Giuseppe Minniti, Enrico Clarke, Claudia Scaringi, Riccardo Maurizi Enrici
DOI: 10.1016/j.rpor.2014.09.004
·
Rep Pract Oncol Radiother 2016;21(4):370-378.

open access

Vol 21, No 4 (2016)
Special Issue Papers
Published online: 2016-07-01
Submitted: 2014-04-21

Abstract

Radiotherapy (RT) is frequently employed in patients with residual or recurrent pituitary adenoma with excellent rates of tumor control and remission of hormonal hypersecretion. Advances in RT have improved with the use of stereotactic techniques either as fractionated stereotactic radiotherapy (FSRT) or stereotactic radiosurgery (SRS), all aiming to improve the dose distribution to the tumor while reducing the amount of normal brain receiving significant doses of radiation. We provide an overview of the recent published literature on the long-term efficacy and adverse effects of stereotactic irradiation in nonfunctioning and secreting pituitary adenomas. Both techniques are associated with excellent clinical outcomes; however, advantages and drawbacks of each of these techniques in terms of local control, hormonal excess normalization, and radiation-induced toxicity remain a matter of debate. In clinical practice, single-fraction SRS may represent a convenient approach to patients with small and medium-sized pituitary adenoma away at least 2[[ce:hsp sp="0.25"/]]mm from the optic chiasm, whereas FSRT is preferred over SRS for lesions >2.5–3[[ce:hsp sp="0.25"/]]cm in size and/or involving the anterior optic pathway.

Abstract

Radiotherapy (RT) is frequently employed in patients with residual or recurrent pituitary adenoma with excellent rates of tumor control and remission of hormonal hypersecretion. Advances in RT have improved with the use of stereotactic techniques either as fractionated stereotactic radiotherapy (FSRT) or stereotactic radiosurgery (SRS), all aiming to improve the dose distribution to the tumor while reducing the amount of normal brain receiving significant doses of radiation. We provide an overview of the recent published literature on the long-term efficacy and adverse effects of stereotactic irradiation in nonfunctioning and secreting pituitary adenomas. Both techniques are associated with excellent clinical outcomes; however, advantages and drawbacks of each of these techniques in terms of local control, hormonal excess normalization, and radiation-induced toxicity remain a matter of debate. In clinical practice, single-fraction SRS may represent a convenient approach to patients with small and medium-sized pituitary adenoma away at least 2[[ce:hsp sp="0.25"/]]mm from the optic chiasm, whereas FSRT is preferred over SRS for lesions >2.5–3[[ce:hsp sp="0.25"/]]cm in size and/or involving the anterior optic pathway.

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Keywords

Fractionated stereotactic radiotherapy; Radiosurgery; Pituitary adenoma; Acromegaly; Cushing' s disease

About this article
Title

Stereotactic radiotherapy and radiosurgery for non-functioning and secreting pituitary adenomas

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 21, No 4 (2016)

Pages

370-378

Published online

2016-07-01

DOI

10.1016/j.rpor.2014.09.004

Bibliographic record

Rep Pract Oncol Radiother 2016;21(4):370-378.

Keywords

Fractionated stereotactic radiotherapy
Radiosurgery
Pituitary adenoma
Acromegaly
Cushing's disease

Authors

Giuseppe Minniti
Enrico Clarke
Claudia Scaringi
Riccardo Maurizi Enrici

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