Michael Brada md frcp frcr

Contents

Biologic Effects of Radiation

Radiation Tolerance of the Central Nervous System Technical Aspects of Conventional Pituitary

Radiotherapy Dose and Fractionation Schemes New Treatment Techniques Effectiveness of Radiotherapy Side Effects of Pituitary Irradiation Results of New Techniques of Radiation Timing of Radiotherapy Conclusions and Recommendations References

The aim of radiotherapy is to inhibit the growth of pituitary tumor mass and to decrease hormone production in secreting tumors. Despite routine use of radiotherapy for the last four decades, there has not been a single randomized study assessing its efficacy and toxicity in comparison to other management strategies. Nevertheless there is considerable information on patient and disease outcome after radiation. The lack of comparative data, however, makes it difficult to separate the effects of the various therapeutic interventions and those of the disease itself. Radiotherapy is generally given after surgery, and the individual contribution of each treatment modality, particularly to long-term morbidity, is also difficult to distinguish. Despite the uncertainties, radiotherapy is an important component of treatment, and a large proportion of patients with pituitary adenoma receive it sometime during the course of their illness.

From: Management of Pituitary Tumors: The Clinician's Practical Guide, Second Edition Edited by: M. P. Powell, S. L. Lightman, and E. R. Laws, Jr. © Humana Press Inc., Totowa, NJ

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