Radiosurgery & Radiation Therapy for Pituitary Tumors

If a portion of pituitary tumor cannot be removed during surgery and medications are not controlling symptoms, NYU Langone doctors may use either radiosurgery—the delivery of a single, high dose of energy to destroy tumor cells—or radiation therapy, the delivery of high-dose energy over several treatment sessions to manage the condition.

NYU Langone radiation oncologists may also use either radiosurgery or radiation therapy to manage pituitary tumors that return after surgery. For example, in people with Cushing’s disease, doctors may use radiation therapy—with or without medications—to shrink pituitary tumors.

In rare instances when a tumor is cancerous, doctors may use radiosurgery or radiation therapy after surgery to destroy any remaining cancer cells.

Our doctors may also consider using these approaches to treat people who are in poor health and cannot have surgery.

Stereotactic Radiosurgery or Gamma Knife Surgery

NYU Langone doctors may use stereotactic radiosurgery, or Gamma Knife® radiosurgery, to manage small pituitary tumors in people who cannot have surgery, as well as small portions of tumors that are not completely removed after surgery. Despite the name, a Gamma Knife® is not a knife, but a system for delivering targeted radiation treatment.

Working together, our neurosurgeons and radiation oncologists use highly detailed MRI and CT studies to create a customized and precise treatment plan. Then, using the Gamma Knife® radiosurgery system, they direct multiple, highly targeted radiation beams to the tumor in one treatment session. Critical neighboring structures, such as the brain and important nerves, only receive a low radiation dose.

Dr. Joshua Silverman and Dr. Douglas Kondziolka Review Images

Dr. Joshua Silverman and Dr. Douglas Kondziolka review images from a recent Gamma Knife® radiosurgery.

Because Gamma Knife® radiosurgery depends on the precise delivery of radiation beams, people being treated wear a head frame during the procedure. This prevents them from moving and allows for the precise positioning of the treatment target.

Gamma Knife® surgery is an outpatient procedure and usually takes only a few hours to complete.

Stereotactic Radiotherapy

Stereotactic radiotherapy uses a linear accelerator, a machine that rotates around you during treatment. It delivers radiation from different directions while minimizing the dose to nearby healthy tissue.

Doctors deliver multiple doses of radiation to the pituitary tumor over the course of several weeks, rather than in one treatment session. This is chosen for more extensive tumors. Treatments are done on an outpatient basis.

External Beam Radiation Therapy

Doctors may use external beam radiation therapy for large pituitary tumors or larger portions of a tumor that remain after surgery.

A linear accelerator delivers external beam radiation therapy to the tumor. Doctors use treatment planning software that incorporates MRI or CT scans—X-rays that create three-dimensional, cross-sectional images of the tumor—to target the tumor precisely.

External beam radiation therapy treatments are broken up into small doses. They are typically given once a day, five days a week, for several weeks. Breaking up the treatments into small doses enables the doctor to deliver enough radiation to effectively destroy the tumor while reducing the risk of side effects.

Managing Side Effects

NYU Langone doctors use targeted radiation therapy to decrease the chance of side effects, such as problems with cognitive function, dry mouth, nausea, and vomiting. If a person experiences one of these side effects, he or she can take other medications or use one of our integrative therapies, which may help ease symptoms.