Next Article in Journal
Complex Determinants of Epithelial: Mesenchymal Phenotypic Plasticity in Ovarian Cancer
Next Article in Special Issue
Predicting Organ-Specific Risk Interactions between Radiation and Chemotherapy in Secondary Cancer Survivors
Previous Article in Journal
Significance of microRNAs in Androgen Signaling and Prostate Cancer Progression
Previous Article in Special Issue
Complex DNA Damage: A Route to Radiation-Induced Genomic Instability and Carcinogenesis
Article Menu
Issue 8 (August) cover image

Export Article

Open AccessReview
Cancers 2017, 9(8), 103;

Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review

Laboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Division of Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8122, Japan
Department of Radiology, Nagaoka Chuo General Hospital, Nagaoka 940-8653, Japan
Author to whom correspondence should be addressed.
Academic Editor: Alexandros G. Georgakilas
Received: 4 June 2017 / Revised: 2 August 2017 / Accepted: 4 August 2017 / Published: 8 August 2017
(This article belongs to the Special Issue Radiation-Induced Carcinogenesis)
Full-Text   |   PDF [6786 KB, uploaded 10 August 2017]   |  


Pituitary adenomas are often treated with radiotherapy for the management of tumor progression or recurrence. Despite the improvement in cure rates, patients treated by radiotherapy are at risk of development of secondary malignancies. We conducted a comprehensive literature review of the secondary intracranial tumors that occurred following radiotherapy to pituitary adenomas to obtain clinicopathological characteristics. The analysis included 48 neuroepithelial tumors, 37 meningiomas, and 52 sarcomas which were published between 1959–2017, although data is missing regarding overall survival and type of irradiation in a significant proportion of the reports. The average onset age for the pituitary adenoma was 37.2 ± 14.4 years and the average latency period before the diagnosis of the secondary tumor was 15.2 ± 8.7 years. Radiotherapy was administered in pituitary adenomas at an average dose of 52.0 ± 19.5 Gy. The distribution of pituitary adenomas according to their function was prolactinoma in 10 (7.2%) cases, acromegaly in 37 (27.0%) cases, Cushing disease in 4 (2.9%) cases, PRL+GH in 1 (0.7%) case, non-functioning adenoma in 57 (41.6%) cases. Irradiation technique delivered was lateral opposing field in 23 (16.7%) cases, 3 or 4 field technique in 27 (19.6%) cases, rotation technique in 10 (7.2%) cases, radio surgery in 6 (4.3%) cases. Most of the glioma or sarcoma had been generated after lateral opposing field or 3/4 field technique. Fibrosarcomas were predominant before 1979 (p < 0.0001). The median overall survival time for all neuroepithelial tumors was 11 months (95% confidence intervals (CI), 3–14). Patients with gliomas treated with radiotherapy exhibited a non-significant positive trend with longer overall survival. The median overall survival time for sarcoma cases was 6 months (95% CI, 1.5–9). The median survival time in patients with radiation and/or chemotherapy for sarcomas exhibited a non-significant positive trend with longer overall survival. In patients treated with radiotherapy for pituitary adenomas, the risk of secondary tumor incidence warrants a longer follow up period. Moreover, radiation and/or chemotherapy should be considered in cases of secondary glioma or sarcoma following radiotherapy to the pituitary adenomas. View Full-Text
Keywords: glioma; meningioma; pituitary adenoma; radiation-induced intracranial tumor; sarcoma glioma; meningioma; pituitary adenoma; radiation-induced intracranial tumor; sarcoma

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Supplementary material


Share & Cite This Article

MDPI and ACS Style

Yamanaka, R.; Abe, E.; Sato, T.; Hayano, A.; Takashima, Y. Secondary Intracranial Tumors Following Radiotherapy for Pituitary Adenomas: A Systematic Review. Cancers 2017, 9, 103.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
Cancers EISSN 2072-6694 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top