Radiation therapy

Irradiation of pituitary tumors is currently carried out using several methods; both radiotherapy (wide-field irradiation – two-, three-field, rotational method) and radiosurgical treatment systems can be used.

For each type of neoplasm of the sellar and parasellar regions there are different indicators for radiation doses, which differ for primary and postoperative irradiation of tumors.

Achieving a decrease in the tumor and clinical and biochemical remission for all types of radiation therapy depends on the size and hormonal activity of the tumor.

The expected maximum effect with a minimum level of complications in patients with neoplasms of the sellar and parasellar regions requires certain criteria, such as the volume of the tumor should not exceed 30 mm3 and the distance to the chiasm and optic nerves should be at least 5 mm.

The effect of radiation therapy is stretched in time for a sufficiently long period and can be 3 to 15 years.

The main possible complications of radiation therapy include:

  • headache, nausea;
  • ischemic disorders of cerebral circulation;
  • radial necrosis of the brain;
  • occurrence of hypopituitary disorders, especially dangerous at a young age;
  • radiation damage to the optic nerves;
  • destructive changes in the bone structures of the base of the skull;
  • possible development of “radio-induced” tumors;

The primary radiation treatment of the pituitary neoplasms in comparison with the surgical method has several disadvantages, especially the time of achieving clinical and biochemical remission. An adequately performed surgical treatment allows immediately reducing the level of pathologically elevated hormones, and eliminating compression of the adjacent structures of the brain. With radiation therapy, this may take years. More justified approach is that with the postoperative irradiation