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Updated: Jun 8, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Pituitary radiotherapy for Cushing's disease
Marco Losa1, Piero Picozzi, Maria Grazia Redaelli
1Department of Neurosurgery, Istituto Scientifico San Raffaele, Università Vita-Salute, Milano, Italy. losa.marco@hsr.it
Neuroendocrinology
|September 11, 2010
Summary
Radiotherapy is an effective second-line treatment for Cushing's disease when surgery fails. It offers good tumor control with manageable side effects, making it a viable option for persistent or recurring cases.
Area of Science:
- Endocrinology
- Neurosurgery
- Radiation Oncology
Background:
- Cushing's disease is primarily treated with pituitary surgery.
- Alternative second-line treatments include repeat surgery, radiation therapy, medical therapy, and bilateral adrenalectomy.
- Fractionated radiotherapy and Gamma Knife radiosurgery are common radiotherapy modalities.
Purpose of the Study:
- To review the efficacy and safety of radiotherapy for persistent or recurrent Cushing's disease.
Main Methods:
- Literature review of radiotherapy efficacy and safety in Cushing's disease patients.
Main Results:
- Radiotherapy achieves Cushing's disease remission in 42-83% of patients, with no significant difference between techniques.
- Tumor growth control ranges from 93-100%.
- New-onset hypopituitarism is the most common side effect (30-50% with fractionated radiotherapy, 11-22% with Gamma Knife); severe side effects are rare.
Conclusions:
- Radiotherapy is an effective second-line treatment for Cushing's disease post-surgery.
- Individual patient assessment of radiotherapy's risks and benefits is crucial for treatment decisions.
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