Objective:

To discuss the role of stereotactic radiosurgery (SRS) in the treatment of pituitary adenomas (PAs), focusing on the incidence, biological mechanisms, predictors, and management strategies for pituitary hormone dysfunction following SRS.

Approach:

Key Findings:

• SRS is more effective in controlling tumor growth than achieving complete endocrine remission in FPAs.
• Tumor shrinkage does not necessarily correlate with hormonal remission.
• Factors influencing endocrine remission include absence of hormone-suppressive medications and higher maximum radiation doses.

Interpretation:

SRS can lead to hypopituitarism, with incidence rates between 21% and 50%, and is associated with various complications.

Limitations:

• Heterogeneity in biochemical remission criteria across studies complicates cross-study comparisons.
• Limited data on long-term endocrine outcomes following SRS.

Conclusion:

SRS is a treatment option for PAs, but careful consideration of its effects on hormone function is necessary.

Sources:

• European Society of Endocrinology Guidelines
• Meta-analysis on Acromegaly
• Gamma Knife Radiosurgery for Cushing’s Disease
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