1st April 2004
IRSA - Professional Association
Summary,


GUIDELINE OBJECTIVE(S)

To provide guidelines about the use of stereotactic radiosurgery in symptomatic patients with imaging identified pituitary adenomas with treatment recommendations to be used by medical and public health professionals

TARGET POPULATION

Men and women >2 years old with imaging identified functional or nonfunctional pituitary adenomas

Note: Patients may or may not be candidates for alternative management strategies that include observation, medical management, surgical resection via transsphenoidal approach or craniotomy, and fractionated radiation therapy.

INTERVENTIONS AND PRACTICES CONSIDERED

Stereotactic Radiosurgery

1. Single procedure or occasionally staged procedure (volume staging) techniques
2. Intraoperative stereotactic guidance
3. Digitally acquired images (computed tomography [CT] or magnetic resonance imaging [MRI])
4. Doses ranging from 11 to 16 Gy for non-functional (nonsecretory) adenomas and from 25 to 35 Gy for hormone normalization in cases of functional (secretory) pituitary adenomas

MAJOR OUTCOMES CONSIDERED

Long-term growth control (stabilization or regression) of non-functional pituitary adenomas and pituitary hormone normalization in cases of functional pituitary adenomas are the primary end points of interest. Maintenance of quality of life, employability, and prevention of adverse radiation effects are also considered.