A six year experience with the postoperative radiosurgical management of pituitary adenomas

Since April 1992, 73 consecutive patients with pituitary adenomas were treated with radiosurgery. There were 31 hormonally inactive adenomas and 42 hormonally active adenomas. All but three patients had been subjected to one or more surgical procedures prior to radiosurgery. Three patients had received fractionated radiotherapy. In the inactive adenoma group, the mean target volume was 4.4 ¿ 3 cm3 and the mean prescription dose was 13.8¿1.5 Gy. In the prolactinoma patients, the mean target volume was 6.7 ¿ 9 cm3 and the mean prescription dose was 14.2 ¿4 Gy. In the acromegalic patients, the mean target volume was 2.9¿2.5 cm3 and the mean prescription dose was 16¿4 Gy. ACTH secreting adenomas had a mean target volume of 3.6 ¿ 5.5 cm3 with a mean prescription dose of 17 ¿4.8 Gy. The mean follow-up time was 28.9 ¿ 21.5 months. Follow-up data was available in 83.6% of the patients. Tumor control was achieved in 98.3% and the endocrinological cure rate was 57%. Pituitary function deteriorated in 19.2%. No patient suffered from radiation induced visual damage. It would seem that postoperative radiosurgery for residual or recurrent pituitary adenomas may be a safe technique that can increase the frequency of therapeutic success.