Radiation Therapy for Recurrent or Residual Pituitary Macroadenoma Invading Extrasellar Structures

Kangpyo Kim, Jaeho Cho, Ju Hyung Moon, Eui Hyun Kim, Hong In Yoon

Research output: Contribution to journalArticlepeer-review


Purpose: This study aimed to evaluate the efficacy of radiation therapy (RT) for recurrent or residual pituitary macroadenoma (PMA) invading extrasellar regions. Materials and Methods: Patients from 2000 to 2020 who received RT with conventional fractionation for recurrent or residual PMA were included. The patients were divided according to the type of tumor [functioning (fx) or non-fx] and the aim of RT (sal-vage RT alone, immediate postoperative RT, delayed postoperative RT). Local and biochemical failure-free rates (FFR) were cal-culated using the Kaplan–Meier method. Results: With a median follow up of 82 months (IQR; 42–132 months), 36 patients treated with conventional RT (total 45–54 Gy in 1.8 or 2 Gy per fraction) for recurrent or residual PMA were analyzed. The 10-year local FFRs after RT for non-fx and fx tumor were 100% and 74.4%, respectively (p=0.047). In the immediate postoperative RT group, the 10-year local FFR was 100%, which was higher than the 90% FFR for salvage RT alone or 80% FFR for the delayed postoperative RT group (overall p=0.043, immediate vs. salvage; p=0.312, immediate vs. delayed; p=0.072). The local FFR was compared according to size of tumor with a cut-off value of 4 cm, and there was no significant difference (10-year local FFR 100% vs. 84.7% for >4 cm vs. <4 cm, p=0.320). The extents of extrasellar re-gion invasion were not predictive of local failure after RT. We found no grade ≥3 acute toxicities or newly developed visual impair-ments as a late toxicity of RT. Conclusion: Conventional RT is safe and effective for the local control of recurrent or residual PMA. Our data suggest that immediate postoperative RT can be beneficial in recurrent or residual PMA, although further studies to evaluate risk factors of treatment failure in terms of treatment and disease characteristics are required.

Original languageEnglish
Pages (from-to)1059-1068
Number of pages10
JournalYonsei medical journal
Issue number12
Publication statusPublished - 2022 Dec 1

Bibliographical note

Funding Information:
of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2020R1F1A1076287).

Publisher Copyright:
© Yonsei University College of Medicine 2022.

All Science Journal Classification (ASJC) codes

  • Medicine(all)


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