[Radiotherapy for Pituitary Tumors:An Overview of the Current Evidence]

Various tumors, such as pituitary neuroendocrine tumors(PitNETs)and craniopharyngiomas, can arise in the sellar/parasellar region. Although surgical removal is the standard therapeutic modality for these pathologies, a single surgery may not be sufficient to provide durable tumor control, given the surrounding critical neurovascular structures. Therefore, adjunctive radiotherapy has a substantial role in treating these neoplasms. There are wide variety of radiotherapy modalities, including photon-based fractionated radiotherapy, stereotactic radiosurgery/radiotherapy, and proton- and carbon-ion beam-based radiotherapies. All modalities have their own advantages and disadvantages and thus need to be selectively used after consideration of their characteristics and existing evidence. In addition, the radiation sensitivity of normal anatomies should be kept in mind. In particular, the optic apparatus is very sensitive to ionizing radiation; thus, meticulous care needs to be taken when creating a radiation plan to avoid optic neuropathy. Overall, if properly used, radiotherapy can provide excellent durable tumor control for PitNETs, craniopharyngiomas, and even chordomas. A judicious combination of surgery and radiotherapy plays a key role in functional preservation without affecting tumor control or overall survival.