Radioterapia nos tumores da hipófise – atualizações e controvérsias

Introduction: Radiotherapy is an effective treatment for residual or recurrent pituitary tumors with tumor volume control and decrease or normalization of excess hormone secretion in the clinically functioning adenomas. The risks of long-term toxicity, being the hypopituitarism the most frequent, make radiation therapy a rarely used second-line treatment.Objectives: To describe efficacy, safety and role of conventional external beam radiotherapy, as well as radiosurgery in the treatment of pituitary tumors.Material and Methods: Search of original or review papers published until January 2012 with the following keywords "pituitary radiotherapy", "radiotherapy for pituitary adenomas", "stereotactic radiotherapy", "pituitary radiosurgery", "radiation therapy", "radiotherapy for Cushing's Disease", "radiotherapy for acromegaly", "radiotherapy for non-functioning pituitary adenomas", "radiotherapy for prolactin-secreting pituitary tumors".Conclusions: Radiotherapy still has a complementary role to surgical resection, although it could be appropriate as a first-line treatment in selected cases. The new modalities of radiation treatment show promising results in the reduction of toxicity as well as in the latency of hormonal response; however more studies are necessary to prove long-term efficacy and safety. (C) 2012 Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Published by Elsevier Espafia, S.L. All rights reserved.