Pashtan Itai, Oh Kevin S, Loeffler Jay S
Harvard Radiation Oncology Program, Boston, MA, USA.
Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
Handb Clin Neurol. 2014;124:317-24. doi: 10.1016/B978-0-444-59602-4.00021-6.
Radiation therapy in the form of fractionated treatment or radiosurgery has an important role in the management of pituitary adenomas. Radiation is a reliable way of gaining local control for radiographically progressing pituitary adenomas. For functioning adenomas that are biochemically recurrent or persistent, radiation therapy is less consistent in offering biochemical normalization and often requires a latency period of years or decades. The decision of when to use radiation therapy is a delicate balance between its benefits and late sequelae, especially in the context of benign disease. Recent technological advances in radiation oncology hold the potential to minimize dose to uninvolved normal tissue and therefore reduce the risk of toxicity.
分次治疗或放射外科形式的放射治疗在垂体腺瘤的管理中具有重要作用。对于影像学进展的垂体腺瘤,放射是实现局部控制的可靠方法。对于生化复发或持续存在的功能性腺瘤,放射治疗在实现生化正常化方面的效果不太稳定,且通常需要数年或数十年的潜伏期。决定何时使用放射治疗是在其益处和晚期后遗症之间进行微妙的权衡,尤其是在良性疾病的背景下。放射肿瘤学的最新技术进展有可能将未受影响的正常组织的剂量降至最低,从而降低毒性风险。