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To minimize the risk for radiation\u2010induced damage of the pituitary function, the therapeutic dose to be applied was limited to 20 grays.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS.<\/jats:title><jats:p>Among 175 patients, 142 patients who had a minimum follow\u2010up of 12 months (mean \u00b1 standard deviation, 81.9 \u00b1 37.2 months) were included in the current study. The local tumor control rate was 96.5%, and the tumor response rate was 32.4%. The mean time (\u00b1 standard deviation) from LINAC\u2010RS to normalization of pathologic hormone secretion was 36.2 \u00b1 24.0 months. The probability for normalization was 34.3% at 3 years and 51.1% at 5 years. The frequency of endocrine cure (defined as the normalization of hormone secretion without specific medication intake) was 35.2% (mean \u00b1 standard deviation time to cure, 42.1 \u00b1 25.0 months). Patients with Cushing disease had a statistically significant greater chance of achieving a cure (<jats:italic>P<\/jats:italic> = .001). Side effects of LINAC\u2010RS were deterioration of anterior pituitary function (12.3%), radiation\u2010induced tissue damage (2.8%), and radiation\u2010induced neuropathy (1.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS.<\/jats:title><jats:p>LINAC\u2010RS using a lower therapeutic radiation dose achieved local tumor control and normalization or cure of hormone secretion comparable to the results achieved with \u03b3\u2010knife RS. Compared with the latter, the time to normalization or endocrine cure was delayed, most probably as a result of dose reduction. However, the lower therapeutic radiation dose did not prevent radiation\u2010induced damage of pituitary function completely. 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