Fractionated radiotherapy can be delivered with high precision with SCRT. Early results of fractionated SCRT suggest similar outcome in tumor and hormonal control as reported for conventional radiotherapy (13,59). Although it is hoped that the reduction of radiation doses to normal brain and reduction in the amount of normal brain receiving high radiation doses will reduce long-term side effects, the evidence to substantiate it is not yet available.
Radiation delivered to pituitary adenoma with radiosurgery (using single large doses with a high-precision stereotactic technique) is only safely possible for small tumors, >5 mm away from the optic apparatus. It is suggested that radiosurgery is associated with faster decline of elevated hormone levels in secreting tumors (see Chapter). The published data are currently not conclusive because radiosurgery is reserved for small tumors with only mildly elevated hormone levels and single doses are relatively modest. The efficacy of radiosurgery in long-term tumor control, particularly in nonfunctioning pituitary adenomas (NFPA), is not defined.
Was this article helpful?