title: Radiotherapy for nonfunctioning pituitary adenomas: from conventional to modern stereotactic radiation techniques.
abstract: The initial management of nonfunctioning pituitary macroadenomas (NFAs) is usually surgery; however, a significant proportion of NFAs may require further treatment. Radiotherapy is currently used in patients with residual tumour and achieves excellent long-term control, but there are concerns about potential late toxicity. Stereotactic radiotherapy, both in the form of radiosurgery or fractionated stereotactic radiotherapy, has been developed as a more accurate technique of irradiation with more precise tumour localization and consequently a reduction in the volume of normal tissue, particularly the brain, irradiated to high radiation doses. A review of the literature suggests that new radiation techniques offer safe and effective treatment for recurrent or residual pituitary adenomas; however longer follow-up is necessary to confirm the excellent tumour control and the potential reduction of long-term radiation toxicity. Currently, radiotherapy has an important role in patients with residual or progressive disease after surgery. Patients with small or no residual tumours after surgery may generally continue on a policy of surveillance without immediate irradiation, in order to avoid the potential toxicity of treatment.
authors.affiliation: Department of Clinical Oncology, Neurooncology Unit, S Andrea Hospital, University La Sapienza, Rome, Italy. giuseppeminniti@libero.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Minniti
authors.forename: Marie-Lise
authors.initials: ML
authors.lastname: Jaffrain-Rea
authors.forename: Mattia
authors.initials: M
authors.lastname: Osti
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Cantore
authors.forename: Riccardo Maurizi
authors.initials: RM
authors.lastname: Enrici
mesh_terms: D000236:Adenoma / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D010911:Pituitary Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use; D016634:Radiosurgery; D050397:Radiotherapy, Intensity-Modulated
chemical_list: D019275:Radiopharmaceuticals