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Neurocognitive changes after radiation to the pituitary region
Patrick Murphy1, Adam Mitchell2, David Edge2
1Department of Neuropsychology, National Hospital of Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK.
Endocrine Reviews
|January 22, 2026
Summary
Radiotherapy for pituitary tumors can cause neurocognitive decline, impacting quality of life. This review highlights assessment challenges and proposes a framework for evaluating cognitive changes in patients undergoing radiation therapy.
Area of Science:
- Neuro-oncology
- Radiation Oncology
- Endocrinology
Background:
- Radiotherapy is crucial for pituitary tumors and nearby diseases.
- Technological advancements in radiotherapy, including proton beam therapy, are significant.
- Late effects of brain radiotherapy, especially neurocognitive decline, pose challenges.
Purpose of the Study:
- To review studies on radiotherapy-induced neurocognitive decline in pituitary patients.
- To identify methodological limitations in existing research.
- To propose a framework for assessing neurocognitive decline in this population.
Main Methods:
- Narrative review of published studies.
- Analysis of radiotherapy techniques and radiobiology concepts.
- Evaluation of neurocognitive assessment methodologies.
Main Results:
- Few studies reported additional cognitive effects of radiotherapy post-surgery.
- Methodological issues, such as lenient assessments and unrepresentative samples, affect negative findings.
- Neurocognitive decline is a significant late effect predicting disability.
Conclusions:
- A standardized framework for assessing neurocognitive decline in pituitary patients is needed.
- Future research and clinical settings can utilize this framework.
- Addressing radiotherapy-induced cognitive effects is vital for patient outcomes.
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