Stereotactic radiosurgery for pituitary adenoma

Abstract

Pituitary adenoma (PA) is a benign tumor that arises from the anterior pituitary gland. PA is categorized into non-functioning and functional types, and each type requires specific treatment strategies. While transsphenoidal surgery (TSS) remains the first choice of PA management, its limitations necessitate adjunctive therapies such as stereotactic radiosurgery (SRS), particularly in cases of residual or recurrent tumors. In this review, we explore the role of SRS in PA, particularly emphasizing its complementary nature with TSS treatment. Additionally, predictive factors and therapeutic considerations in SRS, including tumor volume and hormonal remission criteria, are discussed in relation to various types of functional PAs. Although SRS offers promising outcomes, it is crucial to address potential adverse effects such as hypopituitarism and visual complications, particularly in cases of radiation-induced necrosis and internal carotid artery injuries. Treatment planning strategies to avoid adverse effects are highlighted to achieve optimal therapeutic outcomes.