Clinical Outcomes in Patients with Pituitary Adenoma Treated with Radiotherapy

Abstract

Introduction: Pituitary adenomas represent 16.2% of primary cranial neoplasms and cause significant endocrine and neurological dysfunction. While radiotherapy is used for residual, recurrent, or inoperable tumors, long-term patterns of relapse remain poorly understood.This study analysed the clinical outcomes in patients with pituitary adenoma treated with radiotherapy.

Materials and Methodology: A retrospective cohort study included 14 patients with pituitary adenoma treated with radiotherapy between January 1, 2012, and December 31, 2024 at our centre. Demographics, treatment plans, and pre-/post-radiotherapy MRI characteristics like tumor volume, cavernous sinus involvement, optic chiasm displacement were recorded. Clinical outcomes including tumor control, hormone normalization, and overall survival were analysed.

Results: Among 14 patients (6 males, 8 females; median age 55 years), headache was the most common symptom (85.7%), 11 had visual field defects, 3 had acromegaly, and 10 had functional tumors (71.4%). Macroadenoma was the predominant histology (42.9%). All patients underwent prior surgery (50% transsphenoidal). Radiotherapy was delivered primarily at recurrence (71.4%), with a median interval of 33.7 months from diagnosis. The predominant dose schedule was 50.4 Gy in 28 fractions (78.6%). Post-radiotherapy MRI demonstrated a 24.5% mean tumor volume reduction and a 50% reduction in cavernous sinus involvement and optic chiasm displacement. Median overall survival was 124 months (95% CI: 116–132), with 5-year and 10-year survival rates of 100% and 75%, respectively. Zero recurrences occurred.

Conclusions: Radiotherapy provides excellent local control and symptom relief, achieving meaningful volume reduction and structural decompression in pituitary adenomas.