Pituitary adenoma: A review with an emphasis on radiotherapeutic management

Neurosurgery Quarterly

Volumn 9, Issue 3, 1999, Pages 163-196

  Welsh, James S ^a   Wharam Jr , Moody D ^a  

^a JOHNS HOPKINS UNIVERSITY   (United States)

Author keywords

Pituitary adenoma; Radiotherapy; Stereotactic radiosurgery

Indexed keywords

ACROMEGALY; CANCER RADIOTHERAPY; CUSHING DISEASE; CYTOGENETICS; HISTOPATHOLOGY; HUMAN; HYPOPHYSIS ADENOMA; LINEAR ACCELERATOR; NEUROSURGERY; OPTIC NERVE DISEASE; PREVALENCE; PRIORITY JOURNAL; PROLACTINOMA; RADIATION DOSE FRACTIONATION; RADIOSURGERY; RETROSPECTIVE STUDY; REVIEW; STEREOTAXIC SURGERY;

EID: 0032810331     PISSN: 10506438     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (273)

1. Kovacs K. Pathology of pituitary tumors. Endocrinol Metab Clin North Am 1987;16:529-51.
2. Herman V, Fagin J, Gonsky R, et al. Clonal origin of pituitary adenomas. J Clin Endocrinol Metab 1990;71:1427-33.
3. Max MB, Deck MD, Rottenberg DA. Pituitary metastases: incidence in cancer patients and differentiation from pituitary adenoma. Neurology 1981;33:998-1002.
4. Aaberg TM Jr, Kay M, Sternau L. Metastatic tumors to the pituitary. Am J Ophthal 1995;119:779-85.
5. Kernohan JW, Sayre GP. Tumors of the pituitary gland and infundibulum. Section X, Fascicle 36. Washington, DC: Armed Forces Institute of Pathology; 1956:7-57.
6. Tavaris JM, Pile-Spellman J, eds. Neuroradiology. Baltimore: Williams & Wilkins; 1996.
7. Renn WH, Rhoton AL Jr. Microsurgical anatomy of the sellar region. J Neurosurg 1975;43:288.
8. Sage MR, Blumbergs PC, Mulligan BP, Fowler GW. The diaphragma sellae: its relationship to the configuration of the pituitary gland. Radiology 1982;145:703.
9. Sage MR, Blumbergs PC, Fowler GW. The diaphragma sellae: its relationship to normal sellar variants in frontal radiographic projections. Radiology 1982;145:699.
10. Martin JH, ed. Neuroanatomy: Text and Atlas. New York: Elsevier; 1989.
11. Thorner MO, Vance ML, Hovarth E, et al. The anterior pituitary. In: Wilson JD, Foster DW, eds. Williams Textbook of Endocrinology, 8th ed. Philadelphia: WB Saunders; 1992:221-310.
12. Burrow GN, Wortzman B, Rewcastle NB, et al. Microadenomas of the pituitary and abnormal sellar tomograms in an unselected autopsy series. N Engl J Med 1981;304:156-8.
13. Leavens ME, McCutcheon IF, Samaan NA. Management of pituitary adenomas. Oncology 1992;6:69-79.
14. Hovarth E, Kovacs K. Pathology of prolactin cell adenomas. Semin Diagn Pathol 1986;3:4.
15. Scheithauer BW, Hovarth E, Kovacs KT, et al. Plurihormonal pituitary adenomas. Semin Diagn Pathol 1986;3:69-82.
16. Selman WR, Arafah BM, Roessmann U, et al. Pituitary tumor apoplexy. In: Barrow DL, ed. Perspectives in Neurological Surgery, vol. 1. St. Louis: Quality Medical Publishing; 1990:1-17.
17. Pernicone PJ, Scheithauer BW, Sebo TJ, et al. Pituitary carcinoma: a clinicopathologic study of 15 cases. Cancer 1997;79: 804-12.
18. Thapar K, Kovacs K, Scheithauer BW, et al. Proliferative activity and invasiveness among pituitary adenomas and carcinomas: an analysis using the MIB-1 antibody. Neurosurgery 1996;38:99-107.
19. Thapar K, Scheithauer BW, Kovacs K, et al. p53 expression in pituitary adenomas and carcinomas: correlation with invasiveness and tumor growth fractions. Neurosurgery 1996;38:763-71.
20. Kovacs K, Scheithauer BW, Hovarth E, Lloyd RV. The World Health Organization classification of adenohypophysial neoplasms: a proposed five-tier scheme. Cancer 1996;78:502.
21. Grigsby PW. Pituitary. In: Perez CA, Brady LW, eds. Principles and Practice of Radiation Oncology. Philadelphia: Lippincott-Raven; 1997:829-48.
22. Hardy J, Vezine JL. Transphenoidal neurosurgery of intracranial neoplasms. Adv Neurol 1976;15:261.
23. Kovalic JJ, Mazoujian G, McKeel DW, et al. Immunohistochemistry as a predictor of clinical outcome in patients given postoperative radiation for subtotally resected pituitary adenomas. J Neurooncol 1993;16:227-32.
24. Kovacs K, Hovarth E. Pathology of growth hormone producing tumors of the human pituitary. Semin Diagn Pathol 1986;3:18.
25. Hovarth E, Kovacs K, Singer W, et al. Acidophil stem cell adenoma of the human pituitary: clinicopathological analysis of 15 cases. Cancer 1981;47:761-71.
26. Werner S, Trampe E, Palacios P, et al. Growth hormone producing pituitary adenomas with concomitant hypersecretion of prolactin are particularly sensitive to photon irradiation. Int J Radiat Oncol Biol Phys 1985;11:1713.
27. af Trampe EA, Lundell G, Lax I, Werner S. External irradiation of growth hormone producing pituitary adenomas: prolactin as a marker of hypothalamic and pituitary effects. Int J Radiat Oncol Biol Phys 1991;20:655-60.
28. Scheithauer BW, Kovacs KT, Laws ER Jr, et al. Pathology of invasive pituitary tumors with special reference to functional classification. J Neurosurg 1986;65:733-44.
29. Krishna AY, Phillips LS. Management of acromegaly: a review. Am J Med Sci 1994;308:370-5.
30. Hsu DW, Hakim F, Biller BMK, et al. Significance of proliferating cell nuclear antigen index in predicting pituitary adenoma recurrence. J Neurosurg 1993;78:753.
31. Fisher BJ, Gaspar LE, Stitt LW, Noone BE. Pituitary adenoma in adolescents: a biologically more aggressive disease? Radiology 1994;192:869.
32. Luedecke DK, Herrmann HD, Schulte FJ. Special problems with neurosurgical treatment of hormone-secreting pituitary adenomas in children. Prog Exp Tumor Res 1987;30:362.
33. Haddad SF, Van Gilder JC, Menezes AH. Pediatric pituitary tumors. Neurosurgery 1991;29:509.
34. Landis CA, Harsh G, Lyons J, et al. Clinical characteristics of acromegalic patients whose pituitary tumors contain mutant Gs protein. J Clin Endocrinol Metab 1990;71:1416.
35. O'Brien T, O'Riordan DS, Gharib H, et al. Results of treatment of pituitary disease in MEN, type I. Neurosurgery 1996;39: 273-8.
36. Larsson C, Skogseid B, Oberg K, et al. Multiple endocrine neoplasia type 1 maps to chromosome 11 and is lost in insulinoma. Nature 1988;332:85.
37. Spiegel AM. The molecular basis of disorders caused by defects in G-proteins. Harm Res 1997;47:89-96.
38. Elster AD. Modern imaging of the pituitary. Radiology 1993;187: 1-14.
39. Kucharczyk W, Davis DO, Kelly WM, Sze G, Norman D, Newton TH. Pituitary adenomas: high-resolution MRI at 1.5T. Radiology 1986;161:761-5.
40. Hall WA, Luciano MG, Doppman, et al. Pituitary MRI in normal human volunteers: occult adenomas in the general population. Ann Intern Med 1994;120:817.
41. Elster AD. Sellar susceptibility artifacts: theory and implications. Am J Neuroradiol 1993;14:129.
42. Post KD, McCormick PC, Bello JA. Differential diagnosis of pituitary tumors. Endocrinol Metab Clin North Am 1987;16:609.
43. Hardy J, Beauregard H, Robert F. Prolactin-secreting pituitary adenomas: transsphenoidal microsurgical treatment. In: Robyn C, Harter M, eds. Progress in Prolactin Physiology and Pathology. Amsterdam: Elsevier/North Holland Biomedical; 1978:361.
44. Coulam CB, Annegers JF, Abboud, et al. Pituitary adenoma and oral contraceptives: a case-control study. Fertil Steril 1979;31:25.
45. Mirabelli D, Ciccarelli E, Merletti F. Pituitary adenomas in a cosmetics factory. Br J Industr Med 1987;44:845.
46. Acqui Q, Ferrante L, Fraioli B, et al. Association between intracranial aneurysms and pituitary adenomas. Neurochirurgie 1987; 30:177.
47. Sheline GE, Tyrrell JB. Pituitary adenomas. In: Phillips TL, Pistenmaa DA, eds. Radiation Oncology Annual. New York: Raven Press; 1983:1-35.
48. Selman WR, Arafah BM. The Leavens article reviewed (editorial). Oncology 1992;6:79-80.
49. Klibanski A, Biller BMK, Rosenthal DI, et al. Effects of prolactin and estrogen deficiency in amenorrheic bone loss. J Clin Endocrinol Metab 1988;67:124-30.
50. Klibanski A, Greenspan SL. Increase in bone mass after treatment of hyperprolactinemic amenorrhea. N Engl J Med 1986;315:542.
51. Klibanski A, Zervas NT. Diagnosis and management of hormone-secreting pituitary adenomas. N Engl J Med 1991;324:822.
52. Marie P. Sur deux cas d'acromegalie: Hypertrophie singuliere non congenitale des extremeties superieres, inferieures et cephalique. Rev Med 1886;6:297.
53. Cushing H, Davidoff LM. The pathological findings in four autopsied cases of acromegaly with a discussion of their significance. Monograph 22. New York: The Rockefeller Institute for Medical Research; 1927.
54. Melmed S. Medical progress: acromegaly. N Engl J Med 1990; 322:966.
55. Levin S. Manifestations and treatment of acromegaly. Calif J Med 1972;116:57.
56. Ron E, Gridley G, Hrubec H. Acromegaly and GI cancer. Cancer 1991;68:6854.
57. Cushing H. The basophilic adenomas of the pituitary body and their clinical manifestations. Bull Johns Hopkins Hospital 1932; 50:137-95.
58. Carpenter PC. Diagnostic evaluation of Cushing's disease. Endocrinol Metab Clin North Am 1988;17:445-72.
59. Moore TJ, Dulhy RG, Williams GH, Cain JP. Nelson's syndrome: frequency, prognosis, and effect of prior irradiation. Ann Intern Med 1976;85:731-4.
60. Kasperlik-Zaluska AA, Nielubowicz J, Wislawski J, et al. Nelson's syndrome: incidence and prognosis. Clin Endocrinol (Oxf) 1983;19:693-8.
61. Derome PJ, Delande O, Visot A, et al. Short and long term results after transsphenoidal surgery for Cushing's disease: incidence of recurrences. Advances Biosci 1988;69:375-9.
62. Sheline GE, Boldrey EB, Phillips TL. Chromophobe adenomas of the pituitary gland. AJR 1964;92:160.
63. Sheline GE. Treatment of chromophobe adenomas of the pituitary gland and acromegaly. In: Kohler PO, Ross GT, eds. Diagnosis and Treatment of Pituitary Tumors. Amsterdam: Excerpta Medica; 1973:201-16.
64. Roth J, Gorden P, Brace K. Efficacy of conventional pituitary irradiation in acromegaly. N Engl J Med 1970;282:1386.
65. Wright AD, Hill DM, Lowy C, et al. Mortality in acromegaly. Q J Med 1970;39:1-16.
66. Schlecthe JA, Dolan K, Sherman B, Chapler F, Luciano A. The natural history of untreated hyperprolactinemia: a prospective analysis. J Clin Endocrinol Metab 1989;68:412-8.
67. March CM, Kletzky OA, Davajan V, et al. Longitudinal evaluation of patients with untreated prolactin-secreting pituitary adenomas. Am J Obstet Gynecol 1981;139:835.
68. Montgomery DAD. Pituitary tumors in Cushing's syndrome. Q J Med 1963;32:365.
69. Oppenheim DS, Kana AR, Sangha, et al. Prevalence of alpha-subunit-hypersecretion in patients with pituitary tumors: clinically nonfunctioning and somatotroph adenomas. J Clin Endocrinol Metab 1990;70:859-64.
70. Liddle GW. Tests of pituitary-adrenal suppressibility in the diagnosis of Cushing's syndrome. J Clin Endocrinol Metab 1960;20: 1539.
71. Grossman AB, Howlett TA, Perry L, et al. CRF in the differential diagnosis of Cushing's syndrome: a comparison with the dexamethasone-suppression test. Clin Endocrinol (Oxf) 1988;29:167.
72. Nieman LK, Chrousos GP, Oldfield EH, Avgerinos PC, Cutler GB Jr, Loriax DL. The ovine corticotrophin-releasing hormone stimulation test and the dexamethasone suppression test in the differential diagnosis of Cushing's syndrome. Ann Intern Med 1986;105:862.
73. Oldfield EH, Chrousos GP, Schulte HM, et al. Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling. N Engl J Med 1985;312:100.
74. Oldfield EH, Doppman JL, Nieman LK, et al. Petrosal sinus sampling with and without corticotrophin-releasing hormone for the differential diagnosis of Cushing's syndrome. N Engl J Med 1991;325:897.
75. Boscaro M, Rampazzo A, Paoletta A, et al. Selective venous sampling in the differential diagnosis of ACTH-dependent Cushing' syndrome. Neuroendocrinology 1992;55:264.
76. Oliverio PJ, Monsein LH, Wand GS, Debrun GM. Bilateral simultaneous cavernous sampling using corticotropin-releasing hormone in the evaluation of Cushing's disease. AJNR Am J Neuroradiol 1996;17:1669-74.
77. Yokota M, Tani E, Maeda Y, et al. Acromegaly associated with suprasellar and pulmonary hemangiopericytomas: a case report. J Neurosurg 1985;62:767-71.
78. Sano T, Asa SL, Kovacs K. Growth hormone-releasing hormone-producing tumors: clinical, biochemical, and morphological manifestations. Endocrine Rev 1978;9:357-73.
79. Federman DD. Pituitary. In: Rubenstein E, Federman DD, eds. Scientific American Medicine. New York: Scientific American; 1992:3(V):1-17.
80. Couldwell WT, Weiss MH. Strategies in the management of non-secreting pituitary adenomas. In: Cooper PR, ed. Contemporary Diagnosis and Treatment of Pituitary Adenomas. Park Ridge: AANS Publications; 1991:29-35.
81. Wilson CB, Dempsey LC. Transsphenoidal microsurgical removal of 250 pituitary adenomas. J Neurosurg 1978;48:13.
82. Hals JK, Nakstad PH, Kollevold T, Bakke SJ, Skalpe IO. MR imaging of pituitary macroadenomas before and after transsphenoidal surgery. Acta Radiol 1992;33:396-9.
83. Jho HD, Carrau RL. Endoscopic endonasal transsphenoidal surgery: experience with 50 patients. Neurosurg Focus 1996;1:10.
84. Gramegna A. Un cas d'Acromegalie traite par la radiotherapie. Rev Neurol 1909;17:15.
85. Flickinger JC, Deutsch M, Lundsford LD. Repeat megavoltage irradiation of pituitary and suprasellar tumors. Int J Radiat Oncol Biol Phys 1989;17:171-5.
86. Schoenthaler R, Albright NW, Wara WM, et al. Re-irradiation of pituitary adenoma. Int J Radiat Oncol Biol Phys 1992;24:307-14.
87. Andrews DW. Pituitary adenomas. Curr Opin Oncol 1994;6:53.
88. Lamberts SWJ, MacLeod RM. Prolactinomas: medical treatment. In: Landolt AM, Vance ML, Reilly PL, eds. Pituitary Adenomas: Biology, Diagnosis and Treatment. Edinburgh: Churchill Livingstone; 1996:431-41.
89. Molitch ME, Elton RL, Blackwell RE, et al. Bromocriptine as primary therapy for prolactin-secreting macroadenomas: results of a prospective multicenter study. J Clin Endocrinol Metab 1985;60:698-705.
90. Thomer MO, Evans WS, Vance ML. Medical management of prolactinomas. In: Black MP, Zervas NY, Ridgawy EC, Martin JB, eds. Secretory Tumors of the Pituitary Gland. New York: Raven Press; 1984:53-63.
91. Bevan JS, Webster J, Burkee CW, et al. Dopamine agonists and pituitary shrinkage. Endocrinol Rev 1992;13:220-40.
92. Thorner MO, Perryman RL, Rogol AD, et al. Rapid changes of prolactinoma volume after withdrawal and reinstitution of bromocriptine. J Clin Endocrinol Metab 1981;53:480-3.
93. Zarate A, Canales ES, Cano C, et al. Follow-up of patients with prolactinomas after discontinuation of long-term therapy with bromocriptine. Acta Endocrinol (Copenh) 1983;104:139.
94. Youssen DM, Arrington JA, Zinreich SJ, et al. Pituitary adenomas: possible role of bromocriptine in intratumoral hemorrhage. Radiology 1989;170:239.
95. Missale C, Boroni F, Losa M, et al. Nerve growth factor suppresses the transforming phenotype of human prolactinomas. Proc Natl Acad Sci U S A. 1993;90:7961.
96. Yin D, Kondo S, Takeuchi J, et al. Induction of apoptosis in murine ACTH-secreting pituitary adenoma cells by bromocriptine. FEBS Lett 1994;339(1-2):73.
97. Yin D, Kondo S, Takeuchi J, Morimura T. Induction of apoptosis in rat somatotrophin-secreting pituitary adenoma cells by bromocriptine. Oncol Res 1993;5:383.
98. Bassetti M, Spada A, Pezzo G, Giannattasio G. Bromocriptine treatment reduces the cell size in human macroprolactinomas: a morphometric study. J Clin Endocrinol Metab 1984;58:268.
99. Webster J. A comparative review of the tolerability profiles of dopamine agonists in the treatment of hyperprolactinemia and the inhibition of lactation. Drug Safety 1996;14:228-38.
100. Hardy J. Transsphenoidal microsurgery of prolactinomas. In: Black PM, Zervas NT, Ridgeway EC, Martin JB, eds. Secreting Tumors of the Pituitary Gland. New York: Raven Press; 1984: 73-81.
101. Buchfelder M, Lierheimer A, Schreel U, et al. Recurrence of hyperprolactinemia detected in long-term follow-up of surgically normalized microprolactinomas (abstr 24). In: Proceedings of the International Symposium on Prolactinomas. Graz, Austria: 1984:73.
102. Fahlbusch R. Transsphenoidal operation for prolactinomas (abstr 27). In: Proceedings of the International Symposium on Prolactinomas. Graz, Austria: 1984:79.
103. Laws ER, Thapar K. Surgical management of pituitary adenomas. Baillieres Clin Endocrinol Metab 1995;9:391.
104. Rodman EF, Molitch ME, Post KD, et al. Long-term follow-up of transsphenoidal selective adenomectomy for prolactinoma. JAMA 1984;252:921-24.
105. Chang RJ, Keye WR JR, Young JR. Detection, evaluation, and treatment of pituitary microadenomas with galactorrhea and amenorrhea. Am J Obstet Gynecol 1977;128:356.
106. Halberg FE, Sheline GE. Radiotherapy of pituitary tumors. Endocrinol Metab Clin North Am 1987;16:667-84.
107. Serri O, Rasio E, Beauregard H, et al. Recurrence of hyperprolactinemia after selective transsphenoidal adenomectomy in women with prolactinoma. N Engl J Med 1983;309:280-3.
108. Barrow DL, Tindall GT, Kovacs K, et al. Clinical and pathologic effects of bromocriptine on prolactin-secreting and other pituitary tumors. J Neurosurg 1984;60:1-7.
109. Bevan JS, Adams CBT, Burke CW, et al. Factors in the outcome of transsphenoidal surgery for prolactinomas and non-functioning pituitary tumors, including preoperative bromocriptine therapy. Clin Endocrinol (Oxf) 1987;26:541.
110. Landolt AM, Osterwalder V. Perivascular fibrosis in prolactinomas: is it increased by bromocriptine? J Clin Endocrinol Metab 1984;58:1179.
111. Grossman A, Besser GM. Prolactinoma. Br Med J 1985;290: 182-4.
112. Hughes MN, Llamas KJ, Yelland ME, et al. Pituitary adenomas: long-term results for radiotherapy alone and postoperative radiotherapy. Int J Radiat Oncol Biol Phys 1993;27:1035-43.
113. Tran LM, Blount L, Horton D, et al. Radiation therapy of pituitary tumors: results in 95 cases. Am J Clin Oncol 1991;14:25-9.
114. Grigsby PW, Stokes S, Marks JE, et al. Prognostic factors and results of radiotherapy alone in the management of pituitary adenomas. Int J Radiat Oncol Biol Phys 1988;15:1103-10.
115. Rush SC, Newall J. Pituitary adenoma: the efficacy of radiotherapy as the sole treatment. Int J Radiat Oncol Biol Phys 1989; 17:165-9.
116. Kleinberg DL, Noel BL, Frantz AG. Galactorrhea: a study of 235 cases including 48 with pituitary tumors. N Engl J Med 1977; 296:589.
117. Gomez F, Reyes FI, Faiman C. Nonpuerperal galactorrhea and hyperprolactinemia: clinical findings, endocrine features and therapeutic responses in 56 cases. Am J Med 1977;62:648.
118. Sheline GE, Grossman A, Jones AE, et al. Radiation therapy for prolactinomas. In: Black PM, Zervas NT, Ridgeway EC, Martin JB, eds. Secreting Tumors of the Pituitary Gland. New York: Raven Press; 1984:93-108.
119. Mehta AE, Reyes FL, Faiman C. Primary radiotherapy of prolactinomas: 8 to 15 year follow-up. Am J Med 1987;83:59-68.
120. Antunes JL, Housepian EM, Frantz AG, et al. Prolactin secreting pituitary tumors. Ann Neurol 1977;2:148-53.
121. Littley MD, Shalet SM, Beardwell CG, et al. Hypopituitarism following external radiotherapy for tumors in adults. Q J Med 1989;70:145-60.
122. Grossman A, Cohen BL, Charlesworth M, et al. Treatment of prolactinomas with megavoltage radiation therapy. Br Med J 1984;288:1105.
123. Tsagarakis S, Grossman A, Plowman PN, et al. Megavoltage pituitary irradiation in the management of prolactinomas: long-term follow-up. Clin Endocrinol (Oxf) 1991;34:399-406.
124. Grigsby PW, Simpson JR, Emami BN, et al. Prognostic factors and results of surgery and postoperative irradiation in the management of pituitary adenomas. Int J Radiat Oncol Biol Phys 1989;16:1411.
125. Rush SC, Cooper PR. Symptom resolution, tumor control and side effects following postoperative radiotherapy for pituitary macroadenomas. Int J Radiat Oncol Biol Phys 1997;37:1031.
126. Clarke SD, Woo SY, Buther EB, et al. Treatment of secretory pituitary adenoma with radiation therapy. Radiology 1993;188: 759-63.
127. Frantz AG, Cogen PH, Chang CH, et al. Long-term evaluation of the results of transsphenoidal surgery and radiotherapy in patients with prolactinoma. In: Crosignani PG, Rubin BL, eds. Endocrinology of Human Infertility: New Aspects. New York: Grune & Stratum; 1981:161-70.
128. Williams M, van Seters AP, Hermans J, et al. Evaluation of the effects of radiotherapy on macroprolactinomas using the decline rate of serum prolactin levels as a dynamic parameter. Clin Oncol 1994;6:102-9.
129. Laws ER, Thapar K. Recurrent pituitary adenoma. In: Landolt AM, Vance ML, Reilly PL, eds. Pituitary Adenomas: Biology, Diagnosis and Treatment. Edinburgh: Churchill Livingstone; 1996:385-93.
130. Laws ER, Chenelle AG, Thapar K. Recurrence after transsphenoidal surgery for pituitary adenomas: clinical and basic science aspects. In: von Werder K, Fahlbusch R, eds. Pituitary Adenomas: From Basic Research to Diagnosis and Therapy. Elsevier Science BV; 1996:3-9.
131. Carpenter PC. Diagnostic evaluation of Cushing's disease. Endocrinol Metab Clin North Am 1988;17:445.
132. Boggan JE, Tyrrell JB, Wilson CB. Transsphenoidal microsurgery for Cushing's disease: report of 100 cases. J Neurosurg 1983;59:195.
133. Mampalam TJ, Tyrrell JB, Wilson CB. Transsphenoidal microsurgery for Cushing's disease: a report of 216 cases. Ann Intern Med 1988;109:487-93.
134. Robert F, Hardy J. Cushing's disease: a correlation of radiological, surgical and pathological findings with therapeutic results. Pathol Res Prac 1991;187:617-21.
135. Tindall GT, Herring CJ, Clark RV, Adams DA, Watts NB. Cushing's disease: results of transsphenoidal microsurgery with emphasis on surgical failures. J Neurosurg 1990;72:363-9.
136. Tahir AH, Sheeler LR. Recurrent Cushing's disease after transsphenoidal surgery. Arch Intern Med 1992;152:977.
137. Fahlbusch R, Buchfelder M, Muller OA. Transsphenoidal surgery for Cushing's disease. J Royal Soc Med 1986;79:262-9.
138. Knappe UJ, Ludecke DK. Persistent and recurrent hypercortisolism after transsphenoidal surgery for Cushing's disease. Acta Neurochir Suppl (Wien) 1996;65:31-4.
139. Lamberts SWJ, van der Lely AJ, de Herder WW. Transsphenoidal selective adenomectomy is the treatment of choice in patients with Cushing's disease: considerations concerning preoperative medical treatment and long-term follow-up. J Clin Endocrinol Metab 1995;80:3111.
140. Fitzgerald PA, Aron DC, Findling W, et al. Cushing's disease: transient secondary adrenal insufficiency after selective removal of pituitary microadenomas. J Clin Endocrinol Metab 1982;54: 413-22.
141. Sonino N, Zielezny M, Fava GA, Fallo F, Boscaro M. Risk factors and long-term outcome in pituitary-dependent Cushing's disease. J Clin Endocrinol Metab 1996;81:2647.
142. Bochicchio D, Losa M, Buchfelder M. Factors influencing the immediate and late outcome of Cushing's disease treated by transsphenoidal surgery: a retrospective study by the European Cushing's Disease Survey Group. J Clin Endocrinol Metab 1995; 80:3114.
143. Ram Z, Nieman LK, Cutler GB Jr, Chrousos GP, Doppman JL, Oldfield EH. Early repeat surgery for persistent Cushing's disease. J Neurosurg 1994;80:37-45.
144. Estrada J, Boronat M, Mielgo M, et al. The long-term outcome of pituitary irradiation after unsuccessful transsphenoidal surgery in Cushing' disease. N Engl J Med 1997;336:172-7.
145. Tsang RW, Brierley JD, Panzarella T, et al. Role of radiation therapy in clinically hormonally-active pituitary adenomas. Radiother Oncol 1996;41:45-53.
146. Orth DN, Liddle GW. Results of treatment in 108 patients with Cushing's syndrome. N Engl J Med 1971;285:243-7.
147. Edmonds MW, Simpson WJ, Meakeh JW. External irradiation of the hypophysis for Cushing's disease. Cal Med Assoc J 1972; 107:860.
148. Heuschele R, Lampe I. Pituitary irradiation for Cushing's syndrome. N Engl J Med 1967;36:243-7.
149. Dohan FC, Raventos A, Boucot N, Rose E. Roentgen therapy on Cushing's syndrome without adrenocortical tumor. J Clin Endocrinol Metab 1957;17:8.
150. Grigsby PW, Simpson JR, Stokes S, et al. Results of surgery and irradiation or irradiation alone for pituitary adenomas. J Neurooncol 1988;6:129-34.
151. Salinger DJ, Brady LW, Miyamoto CT. Radiation therapy in the treatment of pituitary adenomas. Am J Clin Oncol 1992;15:467.
152. Aristizabal S, Caldwell WL, Avila J. The relationship of time-dose fractionation factors to complications in the treatment of pituitary adenomas by irradiation. Int J Radiat Oncol Biol Phys 1977;2:667-73.
153. Littley MD, Shalet SM, Beardwell CG, et al. Long-term follow-up of low-dose external pituitary irradiation for Cushing's disease. Clin Endocrinol (Oxf) 1990;33:445-55.
154. Schteingart DE, Tsao HS, Taylor CI, et al. Sustained remission of Cushing's disease with mitotane and pituitary irradiation. Ann Intern Med 1980;92:613-9.
155. Ross WM, Evered DC, Hunter P, et al. Treatment of Cushing's disease with adrenal blocking drugs and megavoltage therapy to the pituitary. Clin Radiol 1979;30:149.
156. Luton JP, Mahoudeau JA, Bouchard P, et al. Treatment of Cushing's disease O,p'DDD. N Engl J Med 1979;300:459.
157. Howlett TA, Plowman PN, Wass JAH, et al. Megavoltage pituitary irradiation in the management of Cushing's disease and Nelson's syndrome: long-term follow-up. Clin Endocrinol (Oxf) 1989;31:309-23.
158. Styne DM, Grumbach MM, Kaplan SL, et al. Treatment of Cushing's disease in childhood and adolescence by transsphenoidal microadenomectomy. N Engl J Med 1984;310:889-93.
159. Weber A, Trainer PJ, Grossman AB, et al. Investigation, management, and therapeutic outcome in 12 cases of childhood and adolescent Cushing's syndrome. Clin Endocrinol (Oxf) 1995;43: 19-28.
160. Jennings AS, Liddle GW, Orth DN. Results of treating childhood Cushing's disease with pituitary irradiation. N Engl J Med 1977; 297:957.
161. Zierhut D, Flentje M, Adolph J, et al. External radiation of pituitary adenomas. Int J Radiat Oncol Biol Phys 1995;33:307-14.
162. Sharpe GF, Kendall-Taylor P, Prescott RW, et al. Pituitary function following megavoltage therapy for Cushing's disease: long-term follow-up. Clin Endocrinol (Oxf) 1985;22:169-77.
163. Larkins RG, Martin FI. Hypopituitarism after extracranial irradiation: evidence for hypothalamic origin. Br Med J 1973;1(846): 152-3.
164. Littley MD, Shalet SM, Beardwell CG, et al. Radiation-induced hypopituitarism is dose-dependent. Clin Endocrinol (Oxf) 1989; 31:363-73.
165. Lam KS, Wang C, Yeung RT, et al. Hypothalamic hypopituitarism following cranial irradiation for nasopharyngeal carcinoma. Clin Endocrinol (Oxf) 1986;24:643-51.
166. Perry-Keene DA, Connelly JF, Young RA, et al. Hypothalamic hypopituitarism following external radiotherapy for tumors distant from the adenohypophysis. Clin Endocrinol (Oxf) 1976;5: 373-80.
167. Constine LS, Woolf PD, Cann D, et al. Hypothalamic-pituitary dysfunction after radiation for brain tumors. N Engl J Med 1993; 328:87-94.
168. Jadresic A, et al. Long-term effects of yttrium-90 pituitary implantation in acromegaly. Acta Endocrinol 1987;115:301-6.
169. Melmed S. Acromegaly. N Engl J Med 1990;322:966-77.
170. Tindall GT, Oyesiku NM. Transsphenoidal adenomectomy for GH-secreting pituitary adenomas in acromegaly: outcome analysis and determinants of failure. J Neurosurg 1993;78:205.
171. Landolt AM, Illig R, Zapf J. Surgical treatment of acromegaly. In: Lamberts SWJ, ed. Sandostatin in the Treatment of Acromegaly. Berlin: Springer-Verlag; 1988:23-35.
172. Ross DA, Wilson CB. Results of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma in a series of 214 patients. J Neurosurg 1988;68:854.
173. Baskin DS, Boggan JE, Wilson CB. Transsphenoidal microsurgical removal of growth hormone-secreting pituitary adenomas. J Neurosurg 1982;56:634-41.
174. Fahlbusch R, Honegger J, Buchfelder M. Surgical management of acromegaly. Endocrinol Metab Clin North Am 1992;21:3669.
175. Vance ML. Acromegaly: medical treatment. In: Landolt AM, Vance ML, Reilly PL, eds. Pituitary Adenomas: Biology, Diagnosis and Treatment. Edinburgh: Churchill Livingstone; 1996.
176. Bauer W, Briner U, Deopfner W, et al. SMS 201-995: a very potent and selective octapeptide analogue of somatostatin with prolonged action. Life Sci 1982;31:1133.
177. Williams G, Ball J, Lawson R. Analgesic effect of the somatostatin analogue octreotide in headache associated with pituitary tumors. BMJ 1987;295:247.
178. Ezzat S, Snyder PJ, Young WF, et al. Octreotide treatment of acromegaly: a randomized multicenter study. Ann Intern Med 1992;117:711-8.
179. Spinas GA, Zapf J, Landolt AM, et al. Preoperative treatment of 5 acromegalics with a somatostatin analogue: endocrine and clinical observations. Acta Endocrinol (Copenh) 1987;114:249.
180. Barkan AL, Lloyd RV, Chandler WF, et al. Preoperative treatment of acromegaly with long-acting somatostatin analogue SMS 201-995: shrinkage of invasive pituitary macroadenomas and improved surgical remission rate. J Clin Endocrinol Metab 1986; 67:1040-8.
181. Stevenaert A, Beckers A. Presurgical octreotide treatment in acromegaly. Acta Endocrinol 1993;129(suppl 1):18.
182. Plockinger V, Dienemann D, Quabbe HJ. Gastrointestinal side effects of octreotide during long term treatment of acromegaly. J Clin Endocrinol Metab 1990;71:1658.
183. Dowling RH, Hussaini SH, Murphy GM. Gall stones during octreotide therapy. Metabolism 1992;41(suppl 2):22-3.
184. Lamberts SWJ, Reubi JC. Somatostatin analogues in the treatment of acromegaly. Endocrinol Metab Clin North Am 1992;21: 737-52.
185. Wagenaar AH, Harris AG. Dynamics of the acute effects of octreotide, bromocriptine, and both drugs in combination on growth hormone secretion in acromegaly. Acta Endocrinol (Copenh) 1991;125:637-42.
186. Eastman RC, Gorden P, Roth J. Conventional supervoltage irradiation is an effective treatment for acromegaly. J Clin Endocrinol Metab 1979;48:931-40.
187. Eastman RC, Gorden P, Glatstein E, et al. Radiation therapy of acromegaly. Endocrinol Metab Clin North Am 1992;21:693-712.
188. Wass JAH, Laws ER Jr, Randall RV, Sheline GE. The treatment of acromegaly. Clin Endocrinol Metab 1986;15:683.
189. Bloom B, Kramer S. Conventional radiation therapy in the management of acromegaly. In: Black PM, Zervas NT, Ridgeway EC, eds: Secreting Tumors of the Pituitary Gland. New York: Raven Press; 1984:179-190.
190. Chang CH. Radiotherapy of secretory and nonsecretory pituitary adenomas. In: Chang CH, Honaspian EM, eds. Tumors of the Central Nervous System: Modern Radiotherapy in Multidisciplinary Management. New York: Masson; 1982:201-13.
191. Sheline GE, Wara WM. Radiation therapy of acromegaly and nonsecretory chromophobe adenomas of the pituitary. In: Seydel HG, ed. Tumors of the Central Nervous System. New York: Wiley; 1975:119-31.
192. Feek CM, McLelland J, Seth J, et al. How effective is external pituitary irradiation for growth hormone-secreting pituitary tumors? Clin Endocrinol 1984;20:401-8.
193. Pistenmaa DA, Goffinet DR, Bagshaw MA, et al. Treatment of acromegaly with megavoltage radiation therapy. Int J Radiat Oncol Biol Phys 1976;1:885-93.
194. Caruso M, Shaw E, Davis D. Radiation treatment of growth hormone secreting pituitary adenomas (abstract). Int J Radiat Oncol Biol Phys 1991;21(suppl):121-2.
195. Zaugg M, Adaman O, Pescia R, et al. External irradiation of macroinvasive pituitary adenomas with telecobalt: a retrospective study with long-term follow-up in patients treated mostly with doses of between 40-45 Gy. Int J Radiat Oncol Biol Phys 1995; 32:671.
196. McCord MW, Buatti JM, Fennell EM, et al. Radiotherapy for pituitary adenoma: long-term outcome and sequelae. Int J Radiat Oncol Biol Phys 1997;392(2):437-44.
197. Brada M, Rajan B, Traish D, et al. The long-term efficacy of conservative surgery and radiotherapy in the control of pituitary adenomas. Clin Endocrinol (Oxf) 1993;38:571-8.
198. Kramer S. Indication for and results of treatment of pituitary tumors by external radiation. In: Kohler PO, Ross GT, eds. Diagnosis and Treatment of Pituitary Tumors. Amsterdam: Excerpta Medica; 1973:217-29.
199. Sheline GE, Goldberg MB, Feldman R. Pituitary irradiation for acromegaly. Radiology 1961;76:70.
200. Baskin DS, Boggan JE, Wilson CB. Transsphenoidal microsurgical removal of growth hormone-secreting pituitary adenomas. J Neurosurg 1982;56:634.
201. Sheline GE. The role of conventional radiation therapy in the treatment of functional pituitary tumors. In: Linfoot JA, ed. Recent Advances in the Diagnosis and Treatment of Pituitary Tumors. New York: Raven Press; 1979:289-313.
202. Williams RA, Jacobs HS, Kurtz, et al. The treatment of acromegaly with special reference to transsphenoidal hypophysectomy. J Neurosurg 1978;48:13.
203. Urdaneta N, Chessin H, Fischer JL. Pituitary adenomas and craniopharyngiomas: analysis of 99 cases treated with radiation therapy. Int J Radiat Oncol Biol Phys 1976;1:895-902.
204. Liuzzi A, Zingrillo M, Ghiggi MR, et al. Clinically inactive adenomas. In: Landolt AM, Vance ML, Reilly PL, eds. Pituitary Adenomas: Biology, Diagnosis and Treatment. Edinburgh: Churchill Livingstone; 1996.
205. Rush S, Kupersmith MJ, Leuch I, et al. Neuro-opthalmologic assessment of vision before and after radiation therapy alone for pituitary macroadenomas. J Neurosurg 1990;72:594.
206. Cohen AR, Cooper PR, Kupersmith MJ, et al. Visual recovery after transsphenoidal removal of pituitary adenomas. Neurosurg 1985;17:446-52.
207. Flickinger JC, Rush SC. Linear accelerator therapy of pituitary adenomas. In: Landolt AM, Vance ML, Reilly PL, eds. Pituitary Adenomas: Biology, Diagnosis and Treatment. Edinburgh: Churchill Livingstone; 1996:475-483.
208. Coke CC, Fitzpatrick M, Corn BW, et al. 20-year MR imaging and CT scan follow-up of pituitary adenomas: tumor regression and the implications for radiotherapy. Radiology 1997;205 (suppl):308-9.
209. Tsang RW, Brierley JD, Panzarella T, et al. Radiation therapy for pituitary adenoma: treatment outcome and prognostic factors. Int J Radiat Oncol Biol Phys 1994;30:557-65.
210. Flickinger JC, Nelson PB, Martinez AJ, et al. Radiotherapy of nonfunctional adenomas of the pituitary gland: results of long-term follow-up. Cancer 1989;63:2409-14.
211. Fisher BJ, Gaspar LE, Noone B. Giant pituitary adenomas: role of radiotherapy. Int J Radiat Oncol Biol Phys 1993;25:677-81.
212. Chun M, Gabriela MB, Hetelekidis S. Radiotherapy in the treatment of pituitary adenomas. Int J Radiat Oncol Biol Phys 1988; 15:305-9.
213. Comett MS, Paris KJ, Spanos WJ Jr, Lindberg RD, Jose B. Radiation therapy for pituitary adenomas: a retrospective study of the University of Louisville experience. Am J Clin Oncol 1996; 19:292.
214. Ciric I, Mikhael M, Stafford T, Lawson L, Garces R. Transsphenoidal neurosurgery of pituitary macroadenomas with long-term follow-up results. J Neurosurg 1983;59:395-401.
215. Brada M, Ford D, Ashley S, et al. Risk of second brain tumor after conservative surgery and radiotherapy for pituitary adenoma. Br Med J 1992;304:1343.
216. Abs R, Parizel PM, Willems PJ, et al. The association of meningioma and pituitary adenoma: report of seven cases and review of the literature. Eur Neurol 1993;33:416-22.
217. Bliss P, Kerr GR, Gregor A. Incidence of second brain tumors after pituitary irradiation in Edinburgh 1962-1990. Clin Oncol (R Coll Radiol) 1994;6:361-3.
218. Jones B, Samarasekara S, Tan LT, Mayles WP. The influence of air cavities on the optic chiasm dose during pituitary radiotherapy for acromegaly. Br J Radiol 1996;69:723-5.
219. Li C, Halberg FE, Torigoe EW, Evans RF. A conformal technique for irradiation of pituitary tumors. Medical Dosimetry 1997;22: 47-51.
220. Grigsby PW, Simpson JR, Fineberg B. Late regrowth of pituitary adenomas after irradiation and/or surgery. Cancer 1989;63:1308.
221. McCollough WM, Marcus RB Jr, Rhoton AL Jr, et al. Long-term follow-up for pituitary adenoma: the absence of late recurrence after greater than or equal to 4500 cGy. Int J Radiat Oncol Biol Phys 1991;21:607-14.
222. Loeffler JS, Siddon RL, Wen PY, Alexander E III. Stereotactic radiosurgery of the brain using a standard linear accelerator: a study of early and late effects. Radiother Oncol 1990;17:311.
223. Leksell L. The stereotaxic method and radiosurgery of the brain. Acta Chir (Scand) 1951;102:316-9.
224. Backlund EO. Stereotaxic treatment of craniopharyngiomas. In: Hamberger CA, Wersall J, eds. Nobel Symposium 10: Disorders of the Skull Base Region. Stockholm, Sweden: Almqvist & Wiskell; 1969:237-44.
225. Degerblad M, Rahn T, Bergstrand G, Thoren M. Long-term results of stereotactic radiosurgery to pituitary gland in Cushing's disease. Acta Endocrinol 1986;112:310-4.
226. Steiner L, Lindquist C, Steiner M. Radiosurgery. Adv Tech Stand Neurosurg 1992;19:21-97.
227. Thoren M, Rahn T, Guo WY, et al. Stereotactic radiosurgery with cobalt-60 gamma unit in the treatment of growth hormone-producing pituitary tumors. Neurosurgery 1991;29:663.
228. Pollock BE, Kondziolka D, Lundsford LD, Flickinger JC. Stereotactic radiosurgery for pituitary adenomas: imaging, visual and endocrine results. Acta Neurochir Suppl (Wien) 1994;62:33-8.
229. Seo Y, Fukuora S, Takanashi M, et al. Gamma knife surgery for Cushing's disease. Surg Neurol 1995;43:170.
230. Park YG, Chang JW, Kim EY, et al. Gamma knife surgery in pituitary microadenomas. Yonsei Med J 1996;37:165.
231. Ganz JC, Backlund EO, Thorsen FA. The effects of gamma knife surgery of pituitary adenomas on tumor growth and endocrinopathies. Stereotact Funct Neurosurg 1993;6(suppl):30-7.
232. Ganz JC. Gamma knife treatment of pituitary adenomas. In Landolt AM, Vance ML, Reilly PL, eds. Pituitary Adenomas: Biology, Diagnosis and Treatment. Edinburgh: Churchill Livingstone; 1996:461-73.
233. Ganz JC, Aandereruud S, Kork SJ, Smievoll AI. Tumor volume reduction following gamma knife radiosurgery: the relationship between X-ray and histological findings. Acta Neurochir Suppl (Wien) 1994;62:39.
234. Voges J, Sturm V, Deuss U, et al. Linac-radiosurgery in pituitary adenomas: preliminary results. Acta Neurochir Suppl (Wien) 1996;65:41-3.
235. Rocher FP, Sentenac I, Berger C, et al. Stereotactic radiosurgery: the Lyon experience. Acta Neurochir Suppl (Wien) 1995;63:109-14.
236. Dunbar SF, Loeffler JS. Stereotactic radiation therapy. In: Mauch PM, Loeffler JS, eds. Radiation Oncology: Technology and Biology. Philadelphia: WB Saunders; 1994:237-51.
237. Tishler RB, Loeffler JS, Lundsford LD, et al. Tolerance of the cranial nerves of the cavernous sinus to radiosurgery. Int J Radiat Oncol Biol Phys 1993;27:215.
238. Shrieve DC, Kooy HM, Tarbell NJ, Loeffler JS. Fractionated (relocatable) stereotactic radiotherapy. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 5th ed. Philadelphia: Lippincott-Raven; 1997:3107-14.
239. Loeffler JS, Flickinger JC, Kooy HM. Stereotactic radiosurgery: part II - clinical experience and future directions. Presented at 38th Annual Meeting of American Society of Therapeutic Radiology and Oncology (ASTRO), October 1996.
240. Suit H, Urie M. Proton beams in radiotherapy. J Natl Cancer Inst 1992;84:155.
241. Mitsumori M, Shrieve DC, Alexander E III, et al. Initial clinical results of LINAC-based stereotactic radiosurgery and stereotactic radiotherapy for pituitary adenomas. Int J Radiat Oncol Biol Phys 1998;42:573-80.
242. Urano M, Verhey LJ, Goitein M, et al. Relative biological effectiveness of modulated proton beams in various murine tissues. Int J Radiat Oncol Biol Phys 1984;10:509.
243. Kjellberg RN. Proton beam therapy of pituitary tumors. Proceedings of the International Stereotactic Radiosurgery Symposium, Pittsburgh PA, June, 1991.
244. Kjellberg RN, Masamitsu A. Stereotactic Bragg peak proton beam therapy. In: Lundsford LD, ed. Modern Stereotactic Neurosurgery. Boston: Martinus Nijhoff; 1988:463-70.
245. Fabrikant JI, Levy RP, Steinberg GK, et al. Stereotactic charged-particle radiosurgery: clinical results of treatment of 1200 patients with intracranial arteriovenous malformations and pituitary disorders. Clin Neurosurg 1992;38:472.
246. Levy RP, Fabrikant JI, Frankel KA, et al. Heavy charged particle radiosurgery of the pituitary gland: clinical results of 840 patients. Stereotact Funct Neurosurg 1991;57:22.
247. Ludecke DK, Lutz BS, Niedwovok G. The choice of treatment in incomplete adenomectomy in acromegaly: proton vs. high voltage radiation. Acta Neurochir (Wien) 1989;96:32-8.
248. Cassar J, Doyle FH, Mashiter K Joplin GF. Treatment of Cushing's disease in juveniles with interstitial pituitary irradiation. Clin Endocrinol (Oxf) 1979;11:313-21.
249. Cassar J, Doyle FH, Lewis PD, et al. Treatment of Nelson's syndrome by pituitary implantation of yttrium-90 or gold 198. Br Med J 1976;2:269-72.
250. Quabbe HJ. Treatment of acromegaly by transsphenoidal operation, 90-yttrium implantation and bromocriptine: results in 230 patients. Clin Endocrinol (Oxf) 1982;16:107-19.
251. Fraser R, Doyle F, Joplin GF, et al. The assessment of the endocrine effect and the effectiveness of ablative pituitary treatment by Y-90 and Au-198 implantation. In: Kohler PO, Ross GT, eds. Diagnosis and Treatment of Pituitary Tumors. New York: Excerpta Medica; 1973:35-46.
252. Molinatti GM, Limone P, Porta M. Treatment of Cushing's disease by interstitial pituitary irradiation: short- and long-term follow-up. Panminerva Med 1995;37:1-7.
253. Sandler LM, Richards NT, Carr DH, et al. Long-term follow-up of patients with Cushing's disease treated by interstitial irradiation. J Clin Endocrinol Metab 1987;65:441-7.
254. Moore GF, Masey J, Yonkers AJ, et al. Complications of interstitial radioactive iodine implants for recurrent pituitary adenomas. Ear Nose Throat J 1992;71:306-10.
255. Harris JR, Levene MB. Visual complications following irradiation for pituitary irradiation for pituitary adenomas and craniopharyngiomas. Radiology 1976;120:167-71.
256. Hammer HM. Optic chiasmal radionecrosis. Trans Ophthal Soc UK 1983;103:208-11.
257. Millar JL, Spry NA, Lamb DS, et al. Blindness in patients after external irradiation for pituitary adenomas: two cases occurring after small daily fractional doses. Clin Oncol 1991;3:291-4.
258. Fisher BJ, Gaspar LE, Noone B. Radiation therapy of pituitary adenoma: delayed sequelae. Radiology 1993;187:843-6.
259. Grattan-Smith PJ, Morris JG, Langlands AO. Delayed radiation necrosis in patients irradiated for pituitary tumors. J Neurol Neurosurg Psychiatry 1992;55:949-55.
260. Mosvas B, Mosvas TZ, Steinberg SM, et al. Long-term visual changes following pituitary irradiation. Int J Radiat Oncol Biol Phys 1995;33:599-605.
261. Dowsett RJ, Fowble B, Sergott RC, et al. Results of radiotherapy in the treatment of acromegaly: lack of ophthalmologic complications. Int J Radiat Oncol Biol Phys 1990;19:453-9.
262. Brismar K, Bergstrand G. CSF circulation in subjects with the empty sella syndrome. Neuroradiology 1981;21:167-75.
263. Braatvedt GD, Corrall RJM. The empty sella syndrome: much ado about nothing. Br J Hosp Med 1992;47:523-5.
264. Goldsmith BJ, Shrieve DC, Loeffler JS. High efficacy without visual damage: the current status of pituitary radiotherapy. Int J Radiat Oncol Biol Phys 1995;33:765-7.
265. Bowen J, Paulsen CA. Stroke after pituitary irradiation. Stroke 1992;23:908-11.
266. Flickinger JC, Nelson PB, Taylor FH, et al. Incidence of cerebral infarction after radiotherapy for pituitary adenoma. Cancer 1989;63:2404-8.
267. Snyder PJ, Fowble BF, Schatz NJ, et al. Hypothyroidism following radiation therapy of pituitary adenomas. Am J Med 1985;81: 457-62.
268. Littley MD, Shalet SM, Beardwell CG. Radiation and the hypothalamic-pituitary axis. In: Gutin SA, ed. Radiation Injury to the Nervous System. New York: Raven Press; 1991.
269. Grattan-Smith PJ, Morris JG, Shores EA, et al. Neuropsychological abnormalities in patients with pituitary tumors. Acta Neurol Scand 1992;86:626.
270. Waltz TA, Brownell B. Sarcoma: a possible late effect of effective radiation therapy for pituitary adenoma - report of two cases. J Neurosurg 1966;24:901.
271. Ebersold MJ, Quast LM, Laws ER Jr, et al. Long-term results in transsphenoidal removal of nonfunctioning pituitary adenoma. J Neurosurg 1986;64:713.
272. Erlichman C, Meakin J, Simpson W. Review of 154 patients with nonfunctioning pituitary tumors. Int J Radiat Oncol Biol Phys 1979;5:1981-6.
273. Vlahovitch B, Reynaud C, Rhiati J, Mansour H, Hammoud F. Treatment and recurrences in 135 pituitary adenomas. Acta Neurochir Suppl (Wien) 1988;42:120-3.