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Review

Radiotherapy for Pituitary Tumors

In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000.
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Review

Radiotherapy for Pituitary Tumors

Doaa Almeldin et al.
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Excerpt

Pituitary adenomas have been historically managed on a multidisciplinary level with surgery, medical therapy, and radiotherapy to control symptoms secondary to mass-effects and hypersecretion of hormones. While transsphenoidal surgery represents the standard initial approach in the majority of cases, radiotherapy is a valuable and effective treatment option for recurrent adenomas, or lesions not amenable to surgery or medical therapy. Following radiotherapy, tumor growth control (over 90% in most series), plus the normalization of hormones, occurs in a large proportion of treated patients, independent of tumor subtype. Over the last decades, radiotherapy technological advances have allowed the reduction of dose to uninvolved brain while maintaining an effective therapeutic dose to the tumor. This has generated debate on the superiority of some radiotherapy techniques over others. The clinical efficacy of conventionally-fractionated treatment (25 to 30 fractions delivered over 5 to 6 weeks), in the form of 3D-conformal radiotherapy (CRT) or intensity-modulated radiotherapy (IMRT) and the more refined “stereotactic” – highly conformal - fractionated radiotherapy (SFRT), can be compared to that provided by “radio-surgical” (SRS) techniques of irradiation (where the tumor is treated with single high dose of radiation). Due to the lack of randomized control trials addressing this issue, the evidence provided in retrospective studies of different radiotherapy technologies is critically reviewed in this chapter. For complete coverage of all related areas of Endocrinology, please visit our on-line FREE web-text, WWW.ENDOTEXT.ORG.

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