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Modern techniques for pituitary radiotherapy

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Abstract

Radiotherapy (RT) remains an effective treatment for residual or recurrent pituitary adenomas with excellent rates of tumour control and normalisation of excess hormone secretion. The main late toxicity is hypopituitarism: other side effects are rare. We discuss technical developments in the delivery of radiotherapy (stereotactic conformal radiotherapy (SCRT) and stereotactic radiosurgery (SRS)), all aiming to reduce the amount of normal brain receiving significant doses of radiation. We provide a comprehensive review of published data on outcome of conventional fractionated radiotherapy and modern RT techniques. SCRT is a suitable treatment technique for all sizes of pituitary adenoma and efficacy is comparable to conventional RT; the lack of long term follow up means that currently there is no information on potential reduction in the incidence of late radiation induced toxicity. Single fraction SRS can only be safely delivered to small tumours away from critical structures. There is no evidence that it produces faster decline of elevated hormone levels than fractionated treatment and is not associated with lesser morbidity.

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Acknowledgements

This work in this study was supported in part by the Neuro-oncology Research Fund of The Royal Marsden NHS Trust. The Neuro-oncology Unit also received funding from Cancer Research UK and The Royal Marsden NHS Foundation Trust. UK hospitals receive a proportion of their funding from the NHS Executive; the views expressed are those of the authors and not necessarily those of the NHS Executive.

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Authors and Affiliations

  1. Neuro-oncology Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK

    G. Minniti, D. C. Gilbert & M. Brada

  2. Neuro-oncology Unit, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK

    G. Minniti, D. C. Gilbert & M. Brada

  3. Department of Neurological Sciences, NEUROMED Institute, Pozzilli, Isernia, Italy

    G. Minniti

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  1. G. Minniti
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Minniti, G., Gilbert, D.C. & Brada, M. Modern techniques for pituitary radiotherapy. Rev Endocr Metab Disord 10, 135–144 (2009). https://doi.org/10.1007/s11154-008-9106-0

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