Pituitary Tumors

Craniopharyngiomas

Meningiomas

Chordomas

Pituitary Tumors

Management:

• Completely excised non secretory adenoma: Surveillance

• Incompletely excised non secretory adenoma, hormone secretory tumours (Acromegaly, Cushings, Prolactinoma, Nelsons syndrome) not controlled with surgery and /or medical therapy: 3D CRT/SCRT

Dose: 45Gy in 25# in 5 weeks (consider 4 field non coplanar MLC plan)

Craniopharyngiomas

Management:

• Completely excised:  Surveillance

• Incompletely excised /no surgery: RT/SCRT

Dose: 54Gy in 30# in 6 weeks

Meningiomas

Management of benign (low grade) lesions:

• Completely excised: Surveillance

• Incompletely excised /no surgery: local RT

Dose: 54Gyin 30# in 6 weeks

Anaplastic/Malignant meningioma- Localized RT.

Dose: 60Gy in 30# in 6 weeks

Chordomas 

Base of skull chordomas: 60-66 Gy, preferably with IMRT
Spinal chordomas: 50-54 Gy

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