[Pituitary adenomas: multimodal management and modern irradiation techniques].
Pituitary adenomas represent 10 to 20% of all primary brain tumours. The main classifications consider their size, micro- and macroadenomas, and their properties, secreting or non-functioning. These characteristics determine the choice of treatment, surgery and medical therapy on first line in many cases. Conventional radiotherapy, whose efficiency has been demonstrated, is indicated in the post-operative setting for lesions at high risk of relapse, recurrences, contra-indications to surgery and intolerance or resistance to medical therapies. Optimal target volume delineation is critical, owing to the proximity of organs at risk and a risk of late toxicity for these patients who have normal life expectancy. Technological, computering and imaging advances have led to conformal radiotherapy, intensity-modulated treatment and stereotaxy. These new techniques are reviewed through a recent literature search. Local control rates are high, although follow-up is still short. Indications for radiosurgery are restricted by the size of the lesions. Fractionated stereotactic radiotherapy potentially reduces late toxicity, but longer follow-up is necessary.
Département de radiothérapie, centre Antoine-Lacassagne, 33 avenue de Valombrose, Nice cedex, France. mec_chand@yahoo.fr
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Chand-Fouché
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Colin
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Bondiau
D000236:Adenoma / Q000175:diagnosis / Q000628:therapy*; D019583:Dose Fractionation, Radiation; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D058958:Organs at Risk; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000628:therapy*; D016634:Radiosurgery / Q000295:instrumentation / Q000379:methods
D006727:Hormone Antagonists