Radiosurgery & Radiation Oncology for Pituitary Region Tumors
Precision stereotactic radiosurgery & stereotactic radiotherapy are safe and effective treatments for pituitary-region tumors that cannot be completely removed by surgery or controlled with medications.
While most pituitary and related skull base tumors can be completely removed with surgery, others require additional treatments including chemotherapy, immuno-therapy and/or radiotherapy. For such patients with residual pituitary adenomas that cannot be helped with further surgery, and patients with related residual tumors such as craniopharyngiomas, clival chordomas, and sinonasal carcinomas, focused radiation or radiosurgery is often indicated to halt tumor growth.
Determining whether stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT) is appropriate and safe for a given patient depends on several factors, most importantly the tumor type, its precise location relative to the optic nerves and chiasm, its growth rate and what prior treatments have been given.
Our comprehensive team approach which includes our radiation oncologists, neuro-oncologists, medical oncologists and neurosurgeons, allows for a refined treatment plan for each patient using our new Varian Trilogy LINAC.
What is Radiosurgery?
Stereotactic Radiosurgery (SRS) is a single dose or up to 5 doses of highly focused radiation delivered to a tumor or vascular malformation. Radiosurgery is frequently used to treat brain, pituitary and skull base tumors that are not amenable to complete surgical removal or in patients with smaller metastatic brain tumors. Radiosurgery can be delivered by a linear accelerator such as by our Varian Trilogy LINAC or by the Gamma Knife or Cyberknife; the effectiveness of these different forms of radiosurgery in terms of stopping tumor growth appears to be relatively equal. For tumors that are less than 3 mm away from the optic nerves or optic chiasm, fractionated (multiple lower dose radiation treatments) stereotactic radiation (SRT) is typically used to avoid damage to the optic nerves.
Tumor types often treated with SRS: metastatic brain tumors, residual meningiomas, pituitary adenomas, chordomas, schwannomas.
What is Stereotactic Radiotherapy?
Stereotactic Radiotherapy (SRT) is delivery of multiple doses of radiation therapy (up to 30 daily doses) given in a focused fashion to treat a tumor or vascular malformation that is not amenable to a single high dose of radiation (radiosurgery). For tumors that are less than 3 mm away from the optic nerves or optic chiasm or critical brainstem structures, fractionated stereotactic radiation (SRT) is typically used to avoid damage to these critical normal structures. This type of focused stereotactic radiation method allows delivery of a maximal tumor dose to the tumor while minimizing radiation to normal structures.
Tumor types often treated with SRT: residual meningiomas, pituitary adenomas, craniopharyngiomas, chordomas, schwannomas, sinonasal carcinomas.
What is Whole Brain Radiation (WBRT)?
WBRT is delivery of multiple fractions of radiation to a large area of the brain given over several days or weeks. WBRT is used less frequently nowthat SRS and SRT are available. However, there is still a role for WBRT in patients with multiple metastatic brain tumors (typically more than 5) and in patients with other extensive malignant brain tumors such as glioblastoma.