Fractionated radiotherapy for pituitary adenomas

Abstract The role of radiotherapy in pituitary tumors is well established, and radiotherapy most commonly constitutes an adjuvant or salvage treatment after initial surgery. Fractionated radiotherapy, delivered as a conformal or stereotactic fractionated treatment, achieves excellent local tumor control rates and moderate biochemical control rates that vary by the specific adenoma subtype. Fractionated radiotherapy for pituitary tumors is generally well tolerated; toxicities are rare and may comprise anterior hypopituitarism and optical neuropathy, neurocognitive impairment, and secondary malignancies. As recurrences and treatment-related toxicities may occur even after years, long-term follow-up is essential. Novel developments for pituitary radiotherapy comprise the advancements of high-precision techniques for fractionated radiotherapy or the utilization of novel treatment modalities such as proton therapy.