Management of Patients with Nonfunctioning Pituitary Adenomas
Recommendations
Radiosurgery and radiation therapy are recommended for treatment of residual or recurrent NFPAs to lower the risk of subsequent tumor progression.
(Level II)When no residual tumor is present or only a small intrasellar tumor exists postoperatively, serial neuroimaging studies are recommended.
(Level II)Radiosurgery with single-session doses of ≥12 Gy or radiation therapy with fractionated doses of 45 to 54 Gy is recommended for greater local tumor control rate of ≥90% at 5 years after treatment.
(Level II)Assessment of NFPA proliferative index and adrenocorticotrophic hormone staining to identify silent corticotroph adenomas are recommended for providing guidance on the risk of adenoma progression and the benefit of earlier adjuvant radiation.
(Level III)Repeat resection is recommended for the treatment of symptomatic recurrent or residual NFPAs.
(Level III)Recommendation Grading
Overview
Title
Management of Patients with Nonfunctioning Pituitary Adenomas
Authoring Organization
Congress of Neurological Surgeons
Publication Month/Year
November 1, 2016
Last Updated Month/Year
April 13, 2023
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adolescent, Adult
Health Care Settings
Ambulatory, Hospital, Operating and recovery room
Intended Users
Physician, nurse, nurse practitioner, physician assistant
Scope
Assessment and screening, Diagnosis, Management, Treatment
Diseases/Conditions (MeSH)
D000236 - Adenoma, D049913 - ACTH-Secreting Pituitary Adenoma
Keywords
radiosurgery, Stereotactic radiosurgery, Nonfunctioning pituitary adenoma, Residual , Radiation therapy , microsurgical resection, fractionated radiation therapy
Supplemental Methodology Resources
Data Supplement, Data Supplement, Data Supplement, Data Supplement, Data Supplement, Data Supplement, Data Supplement, Data Supplement