Megavoltage pituitary irradiation in the management of prolactinomas: long-term follow-up

In this study, the long-term effects of external beam megavoltage radiotherapy (RT) on endocrine function in prolactinomas were determined. Megavoltage RT produces a progressive fall in serum prolactin in the great majority of patients with prolactinomas, with a relatively low incidence of TSH or ACTH deficiency. As it is now clear that dopamine agonist therapy alone provides sufficient management for microprolactinomas, RT may be used for the long-term control of macroprolactinomas, together with interim dopamine agonist therapy. It allows pregnancy to be safely undertaken but, in view of the delayed onset of gonadal deficiency, its administration should be timed with respect to the desired onset of conception in woman. (author)