title: Pituitary adenoma: the efficacy of radiotherapy as the sole treatment.
abstract: The management of patients with pituitary adenomas by radiotherapy alone, using modern techniques of evaluation and current standards of treatment, has not been examined. This is a retrospective review of 29 such patients with nonfunctional or prolactin secreting pituitary macroadenomas. Patients were analyzed by visual fields, hormone levels, and CT scans. All but one patient received a tumor dose of 4500 cGy in 4 to 5 weeks. The tumor was controlled in 26 of 28 (93%) patients for an observed period of 3 to 14 years. Seventeen of 21 (81%) patients with visual impairment experienced normalization or improvement, and seven of ten (70%) patients with hyperprolactinemia achieved normalization of their serum prolactin levels. Post-treatment CT scanning revealed persistent tumor in nine of 17 patients despite clinical improvement. We conclude that: (a) radiotherapy is an effective treatment for these tumors; (b) doses need not exceed 4500 cGy in 25 fractions; (c) radiation is effective for improving vision; (d) radiation can normalize hyperprolactinemia; and (e) tumor regression is variable and unrelated to observed symptom regression.
authors.affiliation: Division of Radiation Oncology, New York University Medical Center, NY 10016.
authors.forename: S C
authors.initials: SC
authors.lastname: Rush
authors.forename: J
authors.initials: J
authors.lastname: Newall
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D015175:Prolactinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects; D012074:Remission Induction; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity