Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Stereotactic Radiosurgery for Pituitary Adenoma

  • Chapter
  • First Online:
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

  • 1351 Accesses

Abstract

Stereotactic radiosurgery is indicated for residual or recurrent functioning and nonfunctioning pituitary adenomas, with a high rate of tumor control and hormone remission. A higher margin dose is required to achieve endocrine remission in functioning adenomas. The rate of endocrine remission after radiosurgery appears faster than that achieved with fractionated radiation therapy. Fewer complications are found in patients who receive radiosurgery. The most frequent complication following radiosurgery of a pituitary adenoma is hypopituitarism. However, panhypopituitarism occurs only rarely in patients.

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 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
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

References

  1. Vance ML. Treatment of patients with a pituitary adenoma: one clinician’s experience. Neurosurg Focus. 2004;16:E1.

    Article  Google Scholar 

  2. Walton L, Hampshire A, Roper A, Mitchell P, Vaughan P, Forster DM, et al. Development of a relocatable frame technique for Gamma Knife radiosurgery. Technical note. J Neurosurg. 2000;93(Suppl 3):198–202.

    Article  Google Scholar 

  3. Hayashi M, Taira T, Chernov M, Fukuoka S, Liscak R, Yu CP, et al. Gamma Knife surgery for cancer pain-pituitary gland-stalk ablation: a multicenter prospective protocol since 2002. J Neurosurg. 2002;97:433–7.

    Article  Google Scholar 

  4. Iwata H, Sato K, Tatewaki K, Yokota N, Inoue M, Baba Y, et al. Hypofractionated stereotactic radiotherapy with CyberKnife for nonfunctioning pituitary adenoma: high local control with low toxicity. Neuro-Oncology. 2011;13:916–22.

    Article  Google Scholar 

  5. Liscak R, Vladyka V, Marek J, Simonova G, Vymazal J. Gamma Knife radiosurgery for endocrine-inactive pituitary adenomas. Acta Neurochir. 2007;149:999–1006. discussion 1006.

    Article  CAS  Google Scholar 

  6. Park KJ, Kano H, Parry PV, Niranjan A, Flickinger JC, Lunsford LD, et al. Long-term outcomes after Gamma Knife stereotactic radiosurgery for nonfunctional pituitary adenomas. Neurosurgery. 2011;69:1188–99.

    Article  Google Scholar 

  7. Sheehan JP, Starke RM, Mathieu D, Young B, Sneed PK, Chiang VL, et al. Gamma Knife radiosurgery for the management of nonfunctioning pituitary adenomas: a multicenter study. J Neurosurg. 2013;119:446–56.

    Article  Google Scholar 

  8. Starke RM, Williams BJ, Jane JA Jr, Sheehan JP. Gamma Knife surgery for patients with nonfunctioning pituitary macroadenomas: predictors of tumor control, neurological deficits, and hypopituitarism. J Neurosurg. 2012;117:129–35.

    Article  Google Scholar 

  9. Castinetti F, Nagai M, Dufour H, Kuhn JM, Morange I, Jaquet P, et al. Gamma Knife radiosurgery is a successful adjunctive treatment in Cushing’s disease. Eur J Endocrinol. 2007;156:91–8.

    Article  CAS  Google Scholar 

  10. Devin JK, Allen GS, Cmelak AJ, Duggan DM, Blevins LS. The efficacy of linear accelerator radiosurgery in the management of patients with Cushing’s disease. Stereotact Funct Neurosurg. 2004;82:254–62.

    Article  Google Scholar 

  11. Jagannathan J, Sheehan JP, Pouratian N, Laws ER, Steiner L, Vance ML. Gamma Knife surgery for Cushing’s disease. J Neurosurg. 2007;106:980–7.

    Article  Google Scholar 

  12. Kobayashi T. Long-term results of stereotactic Gamma Knife radiosurgery for pituitary adenomas. Specific strategies for different types of adenoma. Prog Neurol Surg. 2009;22:77–95.

    Article  Google Scholar 

  13. Sheehan JP, Xu Z, Salvetti DJ, Schmitt PJ, Vance ML. Results of Gamma Knife surgery for Cushing’s disease. J Neurosurg. 2013;119(6):1486–92.

    Article  Google Scholar 

  14. Wan H, Chihiro O, Yuan S. MASEP Gamma Knife radiosurgery for secretory pituitary adenomas: experience in 347 consecutive cases. J Exp Clin Cancer Res. 2009;28:36.

    Article  Google Scholar 

  15. Lee CC, Vance ML, Xu Z, Yen CP, Schlesinger D, Dodson B, et al. Stereotactic radiosurgery for acromegaly. J Clin Endocrinol Metab. 2014;99:1273–81.

    Article  CAS  Google Scholar 

  16. Castinetti F, Taieb D, Kuhn JM, Chanson P, Tamura M, Jaquet P, 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  CAS  Google Scholar 

  17. Franzin A, Spatola G, Losa M, Picozzi P, Mortini P. Results of Gamma Knife radiosurgery in acromegaly. Int J Endocrinol. 2012;2012:342034.

    Article  Google Scholar 

  18. Jezkova J, Marek J, Hana V, Krsek M, Weiss V, Vladyka V, et al. Gamma Knife radiosurgery for acromegaly – long-term experience. Clin Endocrinol. 2006;64:588–95.

    Article  Google Scholar 

  19. Losa M, Gioia L, Picozzi P, Franzin A, Valle M, Giovanelli M, et al. The role of stereotactic radiotherapy in patients with growth hormone-secreting pituitary adenoma. J Clin Endocrinol Metab. 2008;93:2546–52.

    Article  CAS  Google Scholar 

  20. Sheehan JP, Pouratian N, Steiner L, Laws ER, Vance ML. Gamma Knife surgery for pituitary adenomas: factors related to radiological and endocrine outcomes. J Neurosurg. 2011;114:303–9.

    Article  Google Scholar 

  21. Loeffler JS, Shih HA. Radiation therapy in the management of pituitary adenomas. J Clin Endocrinol Metab. 2011;96:1992–2003.

    Article  CAS  Google Scholar 

  22. Jezkova J, Hana V, Krsek M, Weiss V, Vladyka V, Liscak R, et al. Use of the Leksell Gamma Knife in the treatment of prolactinoma patients. Clin Endocrinol. 2009;70:732–41.

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  24. Liu X, Kano H, Kondziolka D, Park KJ, Iyer A, Shin S, et al. Gamma Knife stereotactic radiosurgery for drug resistant or intolerant invasive prolactinomas. Pituitary. 2013;16:68–75.

    Article  Google Scholar 

  25. Pan L, Zhang N, Wang EM, Wang BJ, Dai JZ, Cai PW. Gamma Knife radiosurgery as a primary treatment for prolactinomas. J Neurosurg. 2000;93(Suppl 3):10–3.

    Article  Google Scholar 

  26. Pouratian N, Sheehan J, Jagannathan J, Laws ER Jr, Steiner L, Vance ML. Gamma Knife radiosurgery for medically and surgically refractory prolactinomas. Neurosurgery. 2006;59:255–66. discussion 255–266.

    Article  Google Scholar 

  27. Tanaka S, Link MJ, Brown PD, Stafford SL, Young WF Jr, Pollock BE. Gamma Knife radiosurgery for patients with prolactin-secreting pituitary adenomas. World Neurosurg. 2010;74:147–52.

    Article  Google Scholar 

  28. Zhang N, Pan L, Wang EM, Dai JZ, Wang BJ, Cai PW. Radiosurgery for growth hormone-producing pituitary adenomas. J Neurosurg. 2000;93(Suppl 3):6–9.

    Article  Google Scholar 

  29. Witt TC. Stereotactic radiosurgery for pituitary tumors. Neurosurg Focus. 2003;14:e10.

    Article  Google Scholar 

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

    Article  Google Scholar 

  31. Gutt B, Wowra B, Alexandrov R, Uhl E, Schaaf L, Stalla GK, et al. Gamma-knife surgery is effective in normalising plasma insulin-like growth factor I in patients with acromegaly. Exp Clin Endocrinol Diabetes. 2005;113:219–24.

    Article  CAS  Google Scholar 

  32. Jagannathan J, Sheehan JP, Pouratian N, Laws ER Jr, Steiner L, Vance ML. Gamma Knife radiosurgery for acromegaly: outcomes after failed transsphenoidal surgery. Neurosurgery. 2008;62:1262–9. discussion 1269–1270.

    Article  Google Scholar 

  33. Xu Z, Lee Vance M, Schlesinger D, Sheehan JP. Hypopituitarism after stereotactic radiosurgery for pituitary adenomas. Neurosurgery. 2013;72:630–7.

    Article  Google Scholar 

  34. Brada M, Ashley S, Ford D, Traish D, Burchell L, Rajan B. Cerebrovascular mortality in patients with pituitary adenoma. Clin Endocrinol. 2002;57:713–7.

    Article  CAS  Google Scholar 

  35. Brada M, Burchell L, Ashley S, Traish D. The incidence of cerebrovascular accidents in patients with pituitary adenoma. Int J Radiat Oncol Biol Phys. 1999;45:693–8.

    Article  CAS  Google Scholar 

  36. Brada M, Ford D, Ashley S, Bliss JM, Crowley S, Mason M, et al. Risk of second brain tumour after conservative surgery and radiotherapy for pituitary adenoma. BMJ. 1992;304:1343–6.

    Article  CAS  Google Scholar 

  37. Minniti G, Osti M, Jaffrain-Rea ML, Esposito V, Cantore G, Maurizi Enrici R. Long-term follow-up results of postoperative radiation therapy for Cushing’s disease. J Neuro-Oncol. 2007;84:79–84.

    Article  Google Scholar 

  38. Buatti JM, Friedman WA, Meeks SL, Bova FJ. The radiobiology of radiosurgery and stereotactic radiotherapy. Med Dosim. 1998;23:201–7.

    Article  CAS  Google Scholar 

  39. Rowe J, Grainger A, Walton L, Silcocks P, Radatz M, Kemeny A. Risk of malignancy after Gamma Knife stereotactic radiosurgery. Neurosurgery. 2007;60:60–5. discussion 65–66.

    Article  Google Scholar 

  40. Lim YJ, Leem W, Park JT, Kim TS, Rhee BA, Kim GK. 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  Google Scholar 

  41. Lee CC, Kano H, Yang HC, Xu Z, Yen CP, Chung WY, et al. Initial Gamma Knife radiosurgery for nonfunctioning pituitary adenomas. J Neurosurg. 2014;120:647–54.

    Article  Google Scholar 

  42. Xu Z, Ellis S, Lee CC, Starke RM, Schlesinger D, Lee Vance M, et al. Silent corticotroph adenomas following Gamma Knife radiosurgery. International journal of radiation oncology biology and physics. Int J Radiat Oncol Biol Phys. 2014;90(4):903–10.

    Article  Google Scholar 

  43. Lee CC, Vance ML, Lopes MB, Xu Z, Chen CJ, Sheehan J. Stereotactic radiosurgery for acromegaly: outcomes by adenoma subtype. Pituitary. 2015;18:326–34.

    Article  Google Scholar 

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

    Article  Google Scholar 

  45. Ludecke DK, Flitsch J, Knappe UJ, Saeger W. Cushing’s disease: a surgical view. J Neuro-Oncol. 2001;54:151–66.

    Article  CAS  Google Scholar 

  46. Chee GH, Mathias DB, James RA, Kendall-Taylor P. Transsphenoidal pituitary surgery in Cushing’s disease: can we predict outcome? Clin Endocrinol. 2001;54:617–26.

    Article  CAS  Google Scholar 

  47. Invitti C, Pecori Giraldi F, de Martin M, Cavagnini F. Diagnosis and management of Cushing’s syndrome: results of an Italian multicentre study. Study Group of the Italian Society of endocrinology on the pathophysiology of the hypothalamic-pituitary-adrenal axis. J Clin Endocrinol Metab. 1999;84:440–8.

    CAS  PubMed  Google Scholar 

  48. Sonino N, Zielezny M, Fava GA, Fallo F, Boscaro M. Risk factors and long-term outcome in pituitary-dependent Cushing’s disease. J Clin Endocrinol Metab. 1996;81:2647–52.

    CAS  PubMed  Google Scholar 

  49. Yap LB, Turner HE, Adams CB, Wass JA. Undetectable postoperative cortisol does not always predict long-term remission in Cushing’s disease: a single centre audit. Clin Endocrinol. 2002;56:25–31.

    Article  CAS  Google Scholar 

  50. Lee CC, Chen CJ, Yen CP, Xu Z, Schlesinger D, Fezeu F, et al. Whole-sellar stereotactic radiosurgery for functioning pituitary adenomas. Neurosurgery. 2014;75:227–37. discussion 237.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

    Cheng-chia Lee

  2. National Yang-Ming University, Taipei, Taiwan

    Cheng-chia Lee

  3. Mayo Clinic, Radiation Oncology, Mayo Clinic School of Medicine, Radiation Oncology, Jacksonville, FL, USA

    Daniel M. Trifiletti

  4. University of Virginia Medical Center, Neurological Surgery, Charlottesville, VA, USA

    Jason P. Sheehan

  5. University of Virginia School of Medicine, Neurological Surgery, Charlottesville, VA, USA

    Jason P. Sheehan

Authors
  1. Cheng-chia Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniel M. Trifiletti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jason P. Sheehan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jason P. Sheehan .

Editor information

Editors and Affiliations

  1. Mayo Clinic, Radiation Oncology, Mayo Clinic School of Medicine Radiation Oncology, Jacksonville, FL, USA

    Daniel M. Trifiletti

  2. Department of Radiation Oncology, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA

    Samuel T. Chao

  3. Sunnybrook Odette Cancer Centre, Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada

    Arjun Sahgal

  4. University of Virginia, Departments of Neurological Surgery and Radiation Oncology, Charlottesville, VA, USA

    Jason P. Sheehan

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lee, Cc., Trifiletti, D.M., Sheehan, J.P. (2019). Stereotactic Radiosurgery for Pituitary Adenoma. In: Trifiletti, D., Chao, S., Sahgal, A., Sheehan, J. (eds) Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-16924-4_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-16924-4_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16923-7

  • Online ISBN: 978-3-030-16924-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation