title: Delayed radiation necrosis of the central nervous system in patients irradiated for pituitary tumours.
abstract: Four cases of delayed radiation necrosis involving the CNS were found in a group of 46 patients irradiated for pituitary tumours over a six year period. This occurred in three of 11 patients with Cushing's disease representing an incidence of 27% in this group. There were no cases among 11 patients with acromegaly or among seven with prolactinomas. One case (6%) was found in the 17 patients with chromophobe adenomas. Standard doses of radiation were delivered to these patients and the findings support suggestions that the metabolic disturbances of Cushing's disease may reduce tolerance to radiation. Our results and a literature review indicate that if radiotherapy is used to treat Cushing's disease, the total dose should be less than 50 Gy at 2 Gy per day fractionation.
authors.affiliation: Department of Neurology, Westmead Hospital, Sydney, Australia.
authors.forename: P J
authors.initials: PJ
authors.lastname: Grattan-Smith
authors.forename: J G
authors.initials: JG
authors.lastname: Morris
authors.forename: A O
authors.initials: AO
authors.lastname: Langlands
mesh_terms: D000236:Adenoma / Q000532:radiotherapy*; D001921:Brain / Q000473:pathology / Q000528:radiation effects*; D003480:Cushing Syndrome / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011939:Mental Recall / Q000528:radiation effects; D008875:Middle Aged; D009336:Necrosis; D009460:Neurologic Examination / Q000528:radiation effects; D009483:Neuropsychological Tests; D010910:Pituitary Irradiation / Q000009:adverse effects*; D010911:Pituitary Neoplasms / Q000532:radiotherapy*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed