Radiation therapy of pituitary adenoma: delayed sequelae

Clinical records and follow-up computed tomographic (CT) scans were reviewed for 134 pituitary adenoma patients who underwent radiation therapy between 1970 and 1988, to determine the long-term clinical and radiologic complication rates for patients treated in a fairly standard manner for nonmalignant disease. The group consisted of 82 males and 52 females aged 16-85 years (median, 46 years). Fifty-nine (44%) of the 134 tumors were secretory. One hundred eighteen patients underwent surgical resection and radiation therapy, and 16 underwent only primary radiation therapy. Ninety-seven percent (130 of 132) of the patients received doses within the range of 45-50 Gy over 25 fractions. Mean clinical follow-up was 101 months, and mean radiologic follow-up (CT) was 8 years. Clinical complications occurred in 7% (nine of 134) of patients. There were two secondary malignancies, three visual complications, and two cases of auditory deterioration, and there were two posttreatment cerebrovascular accidents that may or may not have been related to radiation therapy. Only two of the 82 follow-up CT scans available revealed evidence of ischemic changes within the radiation fields.