Progression of potentially aggressive pituitary neuroendocrine tumors after radiotherapy: risk factors, management, and outcomes
Authors' conclusion
Lactotroph and corticotroph PitNETs, in male patients, and/or with necrotic-hemorrhagic changes are at higher risk of progression after radiotherapy. Patients with progression after radiotherapy require additional heavy treatments with variable outcome.
Study context
- Population
- Consecutive patients who underwent radiotherapy for pituitary neuroendocrine tumors (PitNETs), followed at Cochin Hospital 2000–2022; indication uncontrolled tumor progression (80%), adjuvant (9%) or uncontrolled secretion (11%)
- Participants
- 123 consecutive patients
- Outcome
- Tumor progression after radiotherapy
- Follow-up
- Median 10.0 years
Methodological detailssingle-center, observational
- Single-center
- Observational
Main finding
As reported in the abstract
- Tumor progression after radiotherapy
- 28/123 (23%)
- Risk factor: lactotroph tumor type, HR
- 12.0 (1.2-117.1) (95% CI)
- Risk factor: corticotroph tumor type, HR
- 9.3 (1.3-69.6) (95% CI)
- Risk factor: male sex, HR
- 3.7 (1.6-8.4) (95% CI)
- Risk factor: necrotic-hemorrhagic changes before radiotherapy on MRI, HR
- 3.1 (1.1-8.4) (95% CI)
Observational data: associations, not effects.
Further findings
Management of progression after radiotherapy
- Surgery
- 18/28(64%)
- Temozolomide
- 16/28(57%)
- Re-irradiation
- 8/28(29%)
Outcomes
Patients
- Developed metastases
- 3
- Died because of tumor progression
- 6
Safety
Complications of radiotherapy
- New onset of pituitary deficits (most common)
- 41%
- Other complications (radiation-induced neuroinflammation, cerebrovascular events, second brain tumors) were rare
Original publication
Progression of potentially aggressive pituitary neuroendocrine tumors after radiotherapy: risk factors, management, and outcomes. Eur J Endocrinol. Published 4 July 2025. doi:10.
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