What is the preferred dose and fractionation scheme for patients with pituitary macroadenomas?

Radiation treatment approach for pituitary adenomas is dependent on several factors. This includes whether it is secretory or nonsecretory, and proximity to optic nerves/chiasm. Surgical resection should always be considered as the first approach (with the exception of prolactinomas, which should be treated primarily with medical management).

Post resection, there may be recurrent or residual disease in the cavernous sinus, or disease that remains close to the optic nerve and chiasm. In the case of cavernous sinus invasion, further surgery poses increased risk and radiation treatment is favored over further surgery. Some patients with recurrent disease may not be candidates for further/repeat surgery for a variety of reasons, including medi...