Chapter 25 - Radiotherapy in the Management of Pituitary Adenomas

Abstract

The pituitary gland may give rise to a range of etiologically distinct tumors, necessitating a diverse set of multidisciplinary therapeutic approaches. Radiotherapy is clinically indicated in approximately 50% of cancer patients worldwide [1]. Since the advent of highly conformal, stereotactic radiotherapy approaches, stereotactic radiosurgery (SRS) has become a standard treatment option for residual or recurrent nonfunctioning pituitary adenomas [2]. After 5years in retrospective series [3–6], reported local tumor control rates are high, at more than 90%. In the setting of functioning pituitary adenomas, radiosurgery is generally reserved for residual, recurrent, or refractory disease [7]. This chapter details indications, risks, and benefits of pituitary radiotherapy, as well as differences in treatment approaches between SRS, conventionally fractionated external beam radiotherapy, and proton therapy.