ABSTRACT
External beam radiotherapy (RT) remains an important component of management of patients with pituitary adenoma, and a significant proportion of patients receive it during the course of their illness. Intensity-modulated radiotherapy (IMRT) is a form of conformal radiotherapy (CRT) that can spare critical structures within a concave planning target volume. This is rarely required for pituitary adenomas, and IMRT offers neither technical nor clinical advantage compared with CRT for most sellar nor suprasellar tumors. Stereotactic techniques are a refinement of CRT with improved immobilization, more accurate image coregis-tration, and high-precision treatment delivery. The therapeutic benefit of RT in malignant tumors is considered to be due to cell attrition either as apop-tosis or reproductive cell death as a consequence of radiation-induced DNA damage. Persistent Cushing’s disease after surgery is a frequent indication for RT because medical treatment is a less effective option. Fractionated RT is an effective treatment achieving excellent disease control and normalization of hormone levels.
