LINAC-Radiosurgery (LINAC-RS) in Pituitary Adenomas: Preliminary Results

LINAC-radiosurgery for nonsecreting pituitary adenomas

“…Patient treatment and follow-up were conducted according to a prospective protocol [48,50]. Patients were included suffered from NSA, tumor recurrence, or progressive residual tumor, definable tumor, maximum dimension of 35 mm and a minimal distance of 1-2 mm to the anterior optic system.…”

“…The detailed components of our treatment system are described elsewhere [26,27,41,48,50]. Before 1996, the tumor contour was outlined on stereotactic CT images.…”

Radiation Therapy in the Multimodal Treatment Approach of Pituitary Adenoma

“…So far, 79 patients with recurrent pituitary adenomas have been treated with 12-20 Gy referred to the 65-80% isodose. Initially, neurotoxicity (temporal lobe necrosis) was observed in two patients [96]. After adoption of the guidelines resulting from a risk analysis for radionecrosis [97] and integration of MR imaging into the treatment planning procedure, no severe side effects related to damage of the temporal lobe or optic system were observed in the following patients.…”

“…The time to return to normal hormone levels depends on the pretreatment level and the rate of decline is most likely a function of cell loss which is related to the kinetics of the tumor and an obliteration of the small tumor vessels. There is currently some convincing evidence that radiosurgery or the use of protons produce a faster decline in hormone levels [56,96,100]. For single-dose radiosurgery, it seems that a minimal peripheral dose of 15 Gy is necessary in order to achieve a hormonal effect.…”

From prolactin cell to prolactinoma: implications of ontogenic mechanisms in diagnosis and management

“…Although further follow-up is necessary to evaluate long-term tumor control and hormonal effects, initial results indicate a potential therapeutic role for radiosurgery (Voges et al 1996).…”