Endocrine Issues Related to Stereotactic Radiosurgery in the Vicinity of the Pituitary Gland

Background: It is generally accepted that radiotherapy plays an important role in the management of hormone-secreting pituitary tumors. Recent data suggest that stereotactic radiosurgery may be more effective than conventional radiotherapy in controlling acromegaly and Cushing's syndrome. Hypopituitarism is a well-recognized complication of radiotherapy to the sellar and parasellar regions. Radiation oncologists involved in the management of patients with these disorders should be aware of the endocrine issues pertaining to therapy. Methods: This review article has been written based on extensive clinical experience combined with a review of the relevant literature. Results: Recommendations regarding surveillance and management reflect the personal opinions of the author. They are, however, based on extensive clinical experiences, accepted clinical practices, and published literature in terms of clinical outcomes. Conclusions: Endocrine issues related to stereotactic radiosurgery in the vicinity of the pituitary gland may be characterized as both desired and adverse consequences of therapy. The efficacy of stereotactic radiosurgery in the management of Cushing's disease and acromegaly is well documented. As a result, stereotactic radiosurgery has become the preferred therapeutic modality, when feasible, in patients who require radiotherapy to complement the surgical management of these disorders. However, stereotactic radiosurgery may be complicated by the development of anterior hypopituitarism that requires careful ongoing evaluation and management. Copyright (C) 2010 S. Karger AG, Basel