Skip to main content
SpringerLink
Log in

Radiation Therapy for Pituitary Adenomas

  • Chapter
Diagnosis and Management of Pituitary Disorders

Part of the book series: Contemporary Endocrinology ((COE))

  • 1724 Accesses

Summary

Radiation therapy offers another means of therapy for pituitary adenomas when roles for medical therapy and surgery have been exhausted. Technological advancements in medical physics have revolutionized modern day radiotherapy for pituitary adenomas. A variety of treatment modalities now exist, all of which offer higher degree of accuracy and safety in radiation delivery. Very high tumor local control rates and reasonably high hormonal response rates to radiation therapy can now be achieved with fairly low rates of treatment-related adverse effects. The exception to this remains radiation-induced hypopituitarism which remains an inherent limitation of irradiating the pituitary.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kooy HM, Nedzi LA, Loeffler JS, et al. Treatment planning for stereotactic radiosurgery of intra-cranial lesions. Int J Radiat Oncol Biol Phys 1991;21(3):683–93.

    PubMed  CAS  Google Scholar 

  2. Yoon SC, Suh TS, Jang HS, et al. Clinical results of 24 pituitary macroadenomas with linac-based stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 1998;41(4):849–53.

    PubMed  CAS  Google Scholar 

  3. Mitsumori M, Shrieve DC, Alexander E, et al. Initial clinical results of linac-based stereotactic radiosurgery and stereotactic radiotherapy for pituitary adenomas. Int J Radiat Oncol Biol Phys 1998;42(3):573–80.

    PubMed  CAS  Google Scholar 

  4. 4. Alameda C, Lucas T, Pineda E, et al. Experience in management of 51 non-functioning pituitary adenomas: indications for post-operative radiotherapy. J Endocrinol Invest 2005;28(1):18–22.

    PubMed  CAS  Google Scholar 

  5. Dekkers OM, Pereira AM, Roelfsema F, et al. Observation alone after transsphenoidal surgery for nonfunctioning pituitary macroadenoma. J Endocrinol Metab 2006;91(5):1796–801.

    Article  CAS  Google Scholar 

  6. Park P, Chandler WF, Barkan AL, et al. The role of radiation therapy after surgical resection of nonfunctional pituitary macroadenomas. Neurosurgery 2004;55(1):100–6.

    Article  PubMed  Google Scholar 

  7. Lillehei KO, Kirschman D, Kleinschmidt-DeMasters BK, et al. Reassessment of the role of radiation therapy in the treatment of endocrine-inactive pituitary macroadenomas. Neurosurgery1998;43(3):432–8.

    Google Scholar 

  8. Sheehan JP, Niranjan A, Sheehan JM, et al. Stereotactic radiosurgery for pituitary adenomas: an intermediate review of its safety, efficacy, and role in the neurosurgical treatment armamentarium. J Neurosurg 2005;102:678–91.

    Article  PubMed  Google Scholar 

  9. Iwai Y, Yamanaka K, Yoshioka K. Radiosurgery for nonfunctioning pituitary adenomas. Neurosurgery 2005;56:699–705.

    Article  PubMed  Google Scholar 

  10. Pollock BE, Carpenter PC. Stereotactic radiosurgery as an alternative to fractionated radiotherapy for patients with recurrent or residual nonfunctioning pituitary adenomas. Neurosurgery 2003;53(5):1086–94.

    Article  PubMed  Google Scholar 

  11. Losa M, Valle M, Mortini P, et al. Gamma knife surgery for treatment of residual nonfunctioning pituitary adenomas after surgical debulking. J Neurosurg 2004;100:438–44.

    PubMed  Google Scholar 

  12. Picozzi P, Losa M, Mortini P, et al. Radiosurgery and the prevention of regrowth of incompletely removed nonfunctioning pituitary adenomas. J Neursurg 2005;102(Suppl):71–4.

    Google Scholar 

  13. Milker-Zabel S, Debus J, Thilmann C, et al. Fractionated stereotactically guided radiotherapy and radiosurgery in the treatment of functional and nonfunctional adenomas of the pituitary gland. Int J Radiat Oncol Biol Phys 2001;50(5):1279–86.

    PubMed  CAS  Google Scholar 

  14. Sasaki R, Murakami M, Okamoto Y, et al. The efficacy of conventional radiation therapy in the management of pituitary adenoma. Int J Radiat Oncol Biol Phys 2000;47(5):1337–45.

    PubMed  CAS  Google Scholar 

  15. van den Bergh ACM, van den Berg G, Schoorl MA, et al. Immediate postoperative radiotherapy in residual nonfunctioning pituitary adenoma: beneficial effect on local control without additional negative impact on pituitary function and life expectancy. Int J Radiat Oncol Biol Phys 2007;67(3):863–9.

    PubMed  Google Scholar 

  16. Breen P, Flickinger JC, Kondziolka D, et al. Radiotherapy for nonfunctioning pituitary adenoma: an analysis of long-term tumor control. J Neurosurg 1998;89(6):933–8.

    Article  PubMed  CAS  Google Scholar 

  17. Kokubo M, Sasai K, Shibamoto Y, et al. Long-term results of radiation therapy for pituitary adenoma. J Neurooncol 2000;47(1):79–84.

    Article  PubMed  CAS  Google Scholar 

  18. Ronson BB, Schulte RW, Han KP, et al. Fractionated proton beam irradiation of pituitary adenomas. Int J Radiat Oncol Biol Phys 2005;64(2):425–34.

    PubMed  Google Scholar 

  19. Landolt AM, Haller D, Lomax, N, et al. Stereotactic radiosurgery for recurrent surgically treated acromegaly: comparison with fractionated radiotherapy. J Neurosurg 1998;88:1002–8.

    PubMed  CAS  Google Scholar 

  20. Feigl GC, Bonelli CM, Berghold A, et al. Effects of gamma knife radiosurgery of pituitary adenomas on pituitary function. J Neurosurg 2002;97(Suppl 5):415–21.

    PubMed  Google Scholar 

  21. Colin P, Jovenin N, Delemer B, et al. Treatment of pituitary adenomas by fractionated stereotactic radiotherapy: a prospective study of 110 patients. Int J Radiat Oncol Biol Phys 2005;62(2):333–41.

    PubMed  Google Scholar 

  22. Zhang N, Pan L, Wang EM, et al. Radiosurgery for growth hormone-producing pituitary adenomas. J Neurosurg 2000;93(Suppl 3):6–9.

    PubMed  Google Scholar 

  23. Castinetti F, Taieb D, Kuhn J-M, et al. Outcome of gamma knife radiosurgery in 82 patients with acromegaly: correlation with initial hypersecretion. J Clin Endocrinol Metab 2005;90:4483–8.

    Article  PubMed  CAS  Google Scholar 

  24. Kobayashi T, Mori Y, Uchiyama Y, et al. Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure? J Neurosurg 2005;102(Suppl):119–23.

    PubMed  Google Scholar 

  25. Biermasz NR, van Dulken H, Roelfsema F. Long-term follow-up results of postoperative radiotherapy in 36 patients with acromegaly J Clin Endocrinol Metab 2000;85:2476–82.

    Article  PubMed  CAS  Google Scholar 

  26. Milker-Zabel S, Zabel A, Huber P, et al. Stereotactic conformal radiotherapy in patients with growth hormone-secreting pituitary adenoma. Int J Radiat Oncol Biol Phys 2004;59(4):1088–96.

    Article  PubMed  Google Scholar 

  27. Minniti G, Jaffrain-Rea M-L, Osti M, et al. The long-term efficacy of conventional radiotherapy in patients with GH-secreting pituitary adenomas. Clin Endocrinol 2005;62:210–6.

    Article  Google Scholar 

  28. Barkan AL, Halasz I, Dornfeld KJ, et al. Pituitary irradiation is ineffective in normalizing plasma insulin-like growth factor I in patients with acromegaly. J Clin Endocrinol Metab 1997;82:3187–91.

    Article  PubMed  CAS  Google Scholar 

  29. Attanasio R, Epaminonda P, Motti E, et al. Gamma-knife radiosurgery in acromegaly: a 4-year follow-up study. J Clin Endocrinol Metab 2003;88:3105–12.

    Article  PubMed  CAS  Google Scholar 

  30. Littley MD, Shalet SM, Swindell R, et al. Low-dose pituitary irradiation for acromegaly. Clin Endocrinol (Oxf) 1990;32:261–70.

    CAS  Google Scholar 

  31. Pollock BE, Jacob JT, Brown PD, et al. Radiosurgery of growth hormone-producing pituitary adenomas: factors associated with biochemical remission. J Neurosurg 2007; 106:833–8.

    Article  PubMed  CAS  Google Scholar 

  32. Landolt AM, Haller D, Lomax N, et al. Octreotide may act as a radioprotective agent in acromegaly. J Clin Endocrinol Metab 2000;85:1287–9.

    Article  PubMed  CAS  Google Scholar 

  33. Kjellberg RN, Shintani A, Fanzt AG, et al. Proton beam therapy in acromegaly. N Engl J Med 1968;278:669–95.

    Article  Google Scholar 

  34. Petit JH, Biller BMK, Swearingen B, et al. Proton stereotactic radiosurgery is effective and safe in the management of persistent acromegaly. The Endocrine Society, 88th Annual Meeting, Boston, MA, June 24–27, 2006.

    Google Scholar 

  35. Sheehan JM, Vance ML, Sheehan JP, et al. Radiosurgery for Cushing’s disease after failed transsphenoidal surgery. J Neurosurg 2000;93:738–42.

    PubMed  CAS  Google Scholar 

  36. Minniti G, Osti M, Jaffrain-Rea ML, et al. Long-term follow-up results of postoperative radiation therapy for Cushing’s disease. J Neurooncol 2007; 84(1):79–84.

    Article  PubMed  Google Scholar 

  37. Estrada J, Boronat M, Mielgo M, et al. The long-term outcome of pituitary radiation therapy after unsuccessful transsphenoidal surgery in Cushing’s disease. N Engl J Med 1997;336:172–7.

    Article  PubMed  CAS  Google Scholar 

  38. Petit JH, Biller BMK, Swearingen B, et al. Proton stereotactic radiosurgery is effective and safe in the management of Cushing’s disease. The Endocrine Society, 88th Annual Meeting, Boston, MA, June 24–27, 2006

    Google Scholar 

  39. Castinetti F, Nagai M, Dufour H, et al. Gamma knife radiosurgery is a successful adjunctive treatment in Cushing’s disease. Eur J Endocrinol 2007;156(1):91–8.

    Article  PubMed  CAS  Google Scholar 

  40. Pan L, Zhang N, Wang EM, et al. Gamma knife radiosurgery as a primary treatment for prolactinomas. J Neurosurg 2000;93(Suppl 3):10–3.

    PubMed  Google Scholar 

  41. Tsagarakis S, Grossman A, Plowman PN, et al. Megavoltage pituitary irradiation in the management of prolactinomas: long-term follow-up. Clin Endocrinol (Oxf) 1991;34:399–406.

    CAS  Google Scholar 

  42. Landolt AM, Lomax N. Gamma knife radiosurgery for prolactinomas. J Neurosurg 2000;93(Suppl 3):14–8.

    PubMed  Google Scholar 

  43. Zierhut D, Flentje M, Adolph J, et al. Eternal radiotherapy of pituitary adenomas. Int J Radiat Oncol Biol Phys 1995;33(2):307–14.

    PubMed  CAS  Google Scholar 

  44. Vladyka V, Liscak R, Novotny J, et al. Radiation tolerance of functioning pituitary tissue in gamma knife surgery for pituitary adenomas. Neurosurgery 2003;52(2):309–17.

    Article  PubMed  Google Scholar 

  45. Pai HH, Thornton A, Katznelson L, et al. Hypothalamic/pituitary function following high-dose conformal radiotherapy to the base of skull: demonstration of a dose-effect relationship using dose-volume histogram analysis. Int J Radiat Oncol Biol Phys 2001;49(4):1079–92.

    Article  PubMed  CAS  Google Scholar 

  46. Tischler RB, Loeffler JS, Lunsford LD, et al. Tolerance of cranial nerves of the cavernous sinus to radiosurgery. Int J Radiat Oncol Biol Phys 1993;27:215–21.

    Google Scholar 

  47. Leber KA, Berglöff J, Pendl G. Dose-response tolerance of the visual pathways and cranial nerves of the cavernous sinus to stereotactic radiosurgery. J Neurosurg 1998;88:43–50.

    PubMed  CAS  Google Scholar 

  48. Brada M, Rajan B, Traish D, et al. The long-term efficacy of conservative surgery and radiotherapy in the control of pituitary adenomas. Clin Endocrinol (Oxf) 1993;38:571–8.

    CAS  Google Scholar 

  49. Parsons JT, Bova FJ, Fitzgerald CR, et al. Radiation optic neuropathy after megavoltage external-beam irradiation: analysis of time-dose factors. Int J Radiat Oncol Biol Phys 1994;30(4):755–63.

    PubMed  CAS  Google Scholar 

  50. McCord MW, Buatti JM, Fennell EM, et al. Radiotherapy for pituitary adenoma: long-term outcome and sequelae. Int J Radiat Oncol Biol Phys 1997;39(2):437–44.

    PubMed  CAS  Google Scholar 

  51. Pollock BE, Nippoldt TB, Stafford SL, et al. Results of stereotactic radiosurgery in patients with hormone-producing pituitary adenomas: factors associated with endocrine normalization. J Neurosurg 2002;97:525–30.

    PubMed  Google Scholar 

  52. Izawa M, Hayashi M, Nakaya K, et al. Gamma knife radiosurgery for pituitary adenomas. J Neurosurg 2000;93(Suppl 3):19–22.

    PubMed  Google Scholar 

  53. Tsang RW, Laperriere NJ, Simpson WJ, et al. Glioma arising after radiation therapy for pituitary adenoma. Cancer 1993;72:2227–33.

    Article  PubMed  CAS  Google Scholar 

  54. Bembo SA, Pasmantier R, Davis RP, et al. Osteogenic sarcoma of the sella after radiation treatment of a pituitary adenoma. Endocr Pract 2004;10(4):335–8.

    PubMed  Google Scholar 

  55. Brada M, Burchell L, Ashley S, et al. The incidence of cerebrovascular accidents in patients with pituitary adenoma. Int J Radiat Oncol Biol Phys 1999;45(3):693–8.

    PubMed  CAS  Google Scholar 

  56. Lim YJ, Leem W, Park JT, et al. Cerebral infarction with ICA occlusion after gamma knife radiosurgery for pituitary adenoma: a case report. Stereotact Funct Neurosurg 1999;72(Suppl 1):132–9.

    Article  PubMed  Google Scholar 

  57. Ayuk J, Clayton RN, Holder G, et al. Growth hormone and pituitary radiotherapy, but not serum insulin-like growth factor-I concentrations, predict excess mortality in patients with acromegaly. J Clin Endocrinol Metab 2004;89(4):1613–7.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Helen A. Shih MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jay S. Loeffler MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Neurosurgery Massachusetts, General Hospital Harvard Medical School, Boston, MA, USA

    Brooke Swearingen MD

  2. Neuroendocrine Unit Department of Medicine, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA

    Beverly M. K. Biller MD

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Humana Press, Totowa, NJ

About this chapter

Cite this chapter

Shih, H.A., Loeffler, J.S. (2008). Radiation Therapy for Pituitary Adenomas. In: Swearingen, B., Biller, B.M. (eds) Diagnosis and Management of Pituitary Disorders. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-264-9_17

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-264-9_17

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-922-2

  • Online ISBN: 978-1-59745-264-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation