Radiation therapy and stereotactic radiosurgery for the treatment of Cushings disease: An evidence-based review

Robert M. Starke, Brian J. Williams, Mary Lee Vance, Jason P. Sheehan

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


PURPOSE OF REVIEW: The indications, efficacy, and safety of radiation therapy and stereotactic radiosurgery for Cushings disease are evaluated.We queried PubMed using the terms, 'Cushings disease', 'radiotherapy', and 'radiosurgery', then evaluated each study for the number of patients, method of radiation delivery, type of radiation therapy or radiosurgical device used, treatment parameters (e.g. maximal dose, tumor margin dose), length of follow-up, tumor-control rate, complications, rate of hormone normalization, newly onset loss of pituitary function, and method used to assess endocrine remission. RECENT FINDINGS: A total of 39 peer-reviewed studies with 731 patients were included. The reported rates of tumor-volume control following radiotherapy and radiosurgery vary considerably from 66-100%. Additionally, the reported rates of endocrine remission vary substantially from 17-100%. The incidence of serious complications following radiosurgery is quite low. Although post-treatment hypopituitarism and disease recurrence were uncommon, they did occur, and this underscores the necessity for long-term follow-up in these patients. SUMMARY: Radiosurgery and, in the modern era, less commonly, radiation therapy, offer both well tolerated and reasonably effective treatment for recurrent or residual Cushings adenomas.

Original languageEnglish (US)
Pages (from-to)356-364
Number of pages9
JournalCurrent Opinion in Endocrinology, Diabetes and Obesity
Issue number4
StatePublished - 2010
Externally publishedYes


  • Cushings disease
  • gamma knife
  • radiation therapy
  • radiosurgery

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics


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