Pituitary adenoma: A review with an emphasis on radiotherapeutic management

The optimal management of patients with pituitary adenomas involves a team a specialists from neurosurgery, endocrinology, ophthalmology, and occasionally radiation oncology. Numerous advances have been made in the surgical and medical management of this tumor, and similarly, radiotherapeutic advances have been gained through improvements in radiotherapy techniques, a better understanding of appropriate radiation dose-fractionation schemes, and the development of modern megavoltage linear accelerator-based treatments. Stereotactic radiosurgery is also a relatively new treatment modality for pituitary adenoma. This review provides an overview of pituitary adenoma with particular emphasis on radiotherapeutic management. Because no prospective randomized trials have been conducted to clearly define the role of radiation therapy in the management of pituitary adenoma, the present recommendations are based on the best pooled retrospective data. The authors review the relevant literature and provide their interpretation of this data to provide general management strategies.