{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:24:42Z","timestamp":1794018282413,"version":"4.8.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Stereotactic radiosurgery (SRS) provides a safe and effective therapeutic modality for patients with pituitary adenomas. The mechanism of delayed endocrine deficits based on targeted radiation to the hypothalamic-pituitary axis remains unclear. Radiation to normal neuroendocrine structures likely plays a role in delayed hypopituitarism after SRS. In this multicenter study by the International Radiosurgery Research Foundation (IRRF), the authors aimed to evaluate radiation tolerance of structures surrounding pituitary adenomas and identify predictors of delayed hypopituitarism after SRS for these tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This is a retrospective review of patients with pituitary adenomas who underwent single-fraction SRS from 1997 to 2019 at 16 institutions within the IRRF. Dosimetric point measurements of 14 predefined neuroanatomical structures along the hypothalamus, pituitary stalk, and normal pituitary gland were made. Statistical analyses were performed to determine the impact of doses to critical structures on clinical, radiographic, and endocrine outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The study cohort comprised 521 pituitary adenomas treated with SRS. Tumor control was achieved in 93.9% of patients over a median follow-up period of 60.1 months, and 22.5% of patients developed new loss of pituitary function with a median treatment volume of 3.2 cm\n                      <jats:sup>3<\/jats:sup>\n                      . Median maximal radiosurgical doses to the hypothalamus, pituitary stalk, and normal pituitary gland were 1.4, 7.2, and 11.3 Gy, respectively. Nonfunctioning adenoma status, younger age, higher margin dose, and higher doses to the pituitary stalk and normal pituitary gland were independent predictors of new or worsening hypopituitarism. Neither the dose to the hypothalamus nor the ratio between doses to the pituitary stalk and gland were significant predictors. The threshold of the median dose to the pituitary stalk for new endocrinopathy was 10.7 Gy in a single fraction (OR 1.77, 95% CI 1.17\u20132.68, p = 0.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>SRS for the treatment of pituitary adenomas affords a high tumor control rate with an acceptable risk of new or worsening endocrinopathy. This evaluation of point dosimetry to adjacent neuroanatomical structures revealed that doses to the pituitary stalk, with a threshold of 10.7 Gy, and doses to the normal gland significantly increased the risk of post-SRS hypopituitarism. In patients with preserved pre-SRS neuroendocrine function, limiting the dose to the pituitary stalk and gland while still delivering an optimal dose to the tumor appears prudent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2021.3.jns203812","type":"journal-article","created":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T20:57:41Z","timestamp":1632517061000},"page":"813-821","source":"Crossref","is-referenced-by-count":24,"title":["Dose to neuroanatomical structures surrounding pituitary adenomas and the effect of stereotactic radiosurgery on neuroendocrine function: an international multicenter study"],"prefix":"10.3171","volume":"136","author":[{"given":"I. Jonathan","family":"Pomeraniec","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyuan","family":"Xu","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Chia","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei City, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huai-Che","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei City, Taiwan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Chytka","sequence":"additional","affiliation":[{"name":"Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Liscak","sequence":"additional","affiliation":[{"name":"Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Martinez-Alvarez","sequence":"additional","affiliation":[{"name":"Radiosurgery Unit, Hospital Ruber Internacional, Madrid, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Martinez-Moreno","sequence":"additional","affiliation":[{"name":"Radiosurgery Unit, Hospital Ruber Internacional, Madrid, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Attuati","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Humanitas Clinical and Research Center\u2014IRCCS, Rozzano, Milan, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Picozzi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Humanitas Clinical and Research Center\u2014IRCCS, Rozzano, Milan, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Kondziolka","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Mureb","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Radiation Oncology, NYU Langone Medical Center, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mathieu","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Maillet","sequence":"additional","affiliation":[{"name":"Endocrinology, Universit\u00e9 de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Quebec, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyoshi","family":"Ogino","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Kano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Dade","family":"Lunsford","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad E.","family":"Zacharia","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Mau","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard C.","family":"Tuanquin","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Penn State Health\u2013Hershey Medical Center, Hershey, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Cifarelli","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Arsanious","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Hack","sequence":"additional","affiliation":[{"name":"Radiation Oncology, West Virginia University Medical Center, Morgantown, West Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald E.","family":"Warnick","sequence":"additional","affiliation":[{"name":"Gamma Knife Center, Jewish Hospital, Mayfield Clinic, Cincinnati, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben A.","family":"Strickland","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric L.","family":"Chang","sequence":"additional","affiliation":[{"name":"Radiation Oncology, University of Southern California Keck School of Medicine, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herwin","family":"Speckter","sequence":"additional","affiliation":[{"name":"Centro Gamma Knife Dominicano and Radiology Department, CEDIMAT, Santo Domingo, Dominican Republic;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, University of Alberta, Edmonton, Alberta, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Louisville Hospital, Louisville, Kentucky; 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Cancer. 2004;101(3):613\u2013619."},{"issue":"1","key":"b2","series-title":"Radiology","first-page":"161","article-title":"Incidental pituitary lesions in 1,000 unselected autopsy specimens","volume":"193","author":"Teramoto A","year":"1994","unstructured":"Teramoto A, Hirakawa K, Sanno N, Osamura Y. Incidental pituitary lesions in 1,000 unselected autopsy specimens. Radiology. 1994;193(1):161\u2013164."},{"issue":"8","key":"b3","series-title":"Neuro Oncol","first-page":"916","article-title":"Hypofractionated stereotactic radiotherapy with CyberKnife for nonfunctioning pituitary adenoma: high local control with low toxicity","volume":"13","author":"Iwata H","year":"2011","unstructured":"Iwata H, Sato K, Tatewaki K,  Hypofractionated stereotactic radiotherapy with CyberKnife for nonfunctioning pituitary adenoma: high local control with low toxicity. Neuro Oncol. 2011;13(8):916\u2013922."},{"issue":"10","key":"b4","series-title":"Acta Neurochir (Wien)","first-page":"999","article-title":"Gamma knife radiosurgery for endocrine-inactive pituitary adenomas","volume":"149","author":"Lisc\u00e1k R","year":"2007","unstructured":"Lisc\u00e1k R, Vladyka V, Marek J,  Gamma knife radiosurgery for endocrine-inactive pituitary adenomas. Acta Neurochir (Wien). 2007;149(10):999\u20131006."},{"issue":"6","key":"b5","series-title":"J Neurosurg","first-page":"876","article-title":"Gamma surgery in the treatment of nonsecretory pituitary macroadenoma","volume":"104","author":"Mingione V","year":"2006","unstructured":"Mingione V, Yen CP, Vance ML,  Gamma surgery in the treatment of nonsecretory pituitary macroadenoma. J Neurosurg. 2006;104(6):876\u2013883."},{"issue":"suppl","key":"b6","series-title":"J Neurosurg","first-page":"71","article-title":"Radiosurgery and the prevention of regrowth of incompletely removed nonfunctioning pituitary adenomas","volume":"102","author":"Picozzi P","year":"2005","unstructured":"Picozzi P, Losa M, Mortini P,  Radiosurgery and the prevention of regrowth of incompletely removed nonfunctioning pituitary adenomas. J Neurosurg. 2005;102(suppl):71\u201374."},{"issue":"5","key":"b7","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1325","article-title":"Gamma knife radiosurgery for patients with nonfunctioning pituitary adenomas: results from a 15-year experience","volume":"70","author":"Pollock BE","year":"2008","unstructured":"Pollock BE, Cochran J, Natt N,  Gamma knife radiosurgery for patients with nonfunctioning pituitary adenomas: results from a 15-year experience. Int J Radiat Oncol Biol Phys. 2008;70(5):1325\u20131329."},{"issue":"5)(suppl","key":"b8","series-title":"J Neurosurg","first-page":"408","article-title":"Radiosurgery for residual or recurrent nonfunctioning pituitary adenoma","volume":"97","author":"Sheehan JP","year":"2002","unstructured":"Sheehan JP, Kondziolka D, Flickinger J, Lunsford LD. Radiosurgery for residual or recurrent nonfunctioning pituitary adenoma. J Neurosurg. 2002;97(5)(suppl):408\u2013414."},{"issue":"4","key":"b9","series-title":"J Neurosurg","first-page":"678","article-title":"Stereotactic radiosurgery for pituitary adenomas: an intermediate review of its safety, efficacy, and role in the neurosurgical treatment armamentarium","volume":"102","author":"Sheehan JP","year":"2005","unstructured":"Sheehan JP, Niranjan A, Sheehan JM,  Stereotactic radiosurgery for pituitary adenomas: an intermediate review of its safety, efficacy, and role in the neurosurgical treatment armamentarium. J Neurosurg. 2005;102(4):678\u2013691."},{"issue":"2","key":"b10","series-title":"J Neurosurg","first-page":"446","article-title":"Gamma Knife radiosurgery for the management of nonfunctioning pituitary adenomas: a multicenter study","volume":"119","author":"Sheehan JP","year":"2013","unstructured":"Sheehan JP, Starke RM, Mathieu D,  Gamma Knife radiosurgery for the management of nonfunctioning pituitary adenomas: a multicenter study. J Neurosurg. 2013;119(2):446\u2013456."},{"issue":"6","key":"b11","series-title":"Cancer","first-page":"1355","article-title":"Linear accelerator radiosurgery for pituitary macroadenomas: a 7-year follow-up study","volume":"107","author":"Voges J","year":"2006","unstructured":"Voges J, Kocher M, Runge M,  Linear accelerator radiosurgery for pituitary macroadenomas: a 7-year follow-up study. Cancer. 2006;107(6):1355\u20131364."},{"issue":"6","key":"b12","series-title":"Neurosurgery","first-page":"1188","article-title":"Long-term outcomes after Gamma Knife stereotactic radiosurgery for nonfunctional pituitary adenomas","volume":"69","author":"Park KJ","year":"2011","unstructured":"Park KJ, Kano H, Parry PV,  Long-term outcomes after Gamma Knife stereotactic radiosurgery for nonfunctional pituitary adenomas. Neurosurgery. 2011;69(6):1188\u20131199."},{"issue":"5","key":"b13","series-title":"Neurosurg Focus","first-page":"e9","article-title":"Radiosurgery for nonfunctioning pituitary adenoma","volume":"14","author":"Sheehan JP","year":"2003","unstructured":"Sheehan JP, Kondziolka D, Flickinger J, Lunsford LD. Radiosurgery for nonfunctioning pituitary adenoma. Neurosurg Focus. 2003;14(5):e9."},{"issue":"suppl","key":"b14","series-title":"J Neurosurg","first-page":"153","article-title":"Pituitary insufficiency as a side effect after radiosurgery for pituitary adenomas: the role of the hypothalamus","volume":"113","author":"Feigl GC","year":"2010","unstructured":"Feigl GC, Pistracher K, Berghold A, Mokry M. Pituitary insufficiency as a side effect after radiosurgery for pituitary adenomas: the role of the hypothalamus. J Neurosurg. 2010;113(suppl):153\u2013159."},{"issue":"2","key":"b15","series-title":"Neurosurgery","first-page":"284","article-title":"Long-term outcomes after Gamma Knife radiosurgery for patients with a nonfunctioning pituitary adenoma","volume":"69","author":"Gopalan R","year":"2011","unstructured":"Gopalan R, Schlesinger D, Vance ML,  Long-term outcomes after Gamma Knife radiosurgery for patients with a nonfunctioning pituitary adenoma. Neurosurgery. 2011;69(2):284\u2013293."},{"issue":"1","key":"b16","series-title":"J Neurosurg","first-page":"202","article-title":"Early versus late Gamma Knife radiosurgery following transsphenoidal resection for nonfunctioning pituitary macroadenomas: a matched cohort study","volume":"125","author":"Pomeraniec IJ","year":"2016","unstructured":"Pomeraniec IJ, Dallapiazza RF, Xu Z,  Early versus late Gamma Knife radiosurgery following transsphenoidal resection for nonfunctioning pituitary macroadenomas: a matched cohort study. J Neurosurg. 2016;125(1):202\u2013212."},{"issue":"6","key":"b17","series-title":"Clin Endocrinol (Oxf)","first-page":"571","article-title":"The long-term efficacy of conservative surgery and radiotherapy in the control of pituitary adenomas","volume":"38","author":"Brada M","year":"1993","unstructured":"Brada M, Rajan B, Traish D,  The long-term efficacy of conservative surgery and radiotherapy in the control of pituitary adenomas. Clin Endocrinol (Oxf). 1993;38(6):571\u2013578."},{"issue":"3","key":"b18","series-title":"Neurosurg Rev","first-page":"167","article-title":"Radiotherapy for nonfunctioning pituitary adenomas: from conventional to modern stereotactic radiation techniques","volume":"30","author":"Minniti G","year":"2007","unstructured":"Minniti G, Jaffrain-Rea ML, Osti M,  Radiotherapy for nonfunctioning pituitary adenomas: from conventional to modern stereotactic radiation techniques. Neurosurg Rev. 2007;30(3):167\u2013176."},{"issue":"1","key":"b19","series-title":"J Neurosurg","first-page":"129","article-title":"Gamma Knife surgery for patients with nonfunctioning pituitary macroadenomas: predictors of tumor control, neurological deficits, and hypopituitarism","volume":"117","author":"Starke RM","year":"2012","unstructured":"Starke RM, Williams BJ, Jane JA Jr, Sheehan JP. Gamma Knife surgery for patients with nonfunctioning pituitary macroadenomas: predictors of tumor control, neurological deficits, and hypopituitarism. J Neurosurg. 2012;117(1):129\u2013135."},{"issue":"suppl 1","key":"b20","series-title":"Stereotact Funct Neurosurg","first-page":"111","article-title":"Gamma Knife radiosurgery for pituitary adenomas","volume":"72","author":"Hayashi M","year":"1999","unstructured":"Hayashi M, Izawa M, Hiyama H,  Gamma Knife radiosurgery for pituitary adenomas. Stereotact Funct Neurosurg. 1999;72(suppl 1):111\u2013118."},{"issue":"suppl 3","key":"b21","series-title":"J Neurosurg","first-page":"14","article-title":"Gamma knife radiosurgery for prolactinomas","volume":"93","author":"Landolt AM","year":"2000","unstructured":"Landolt AM, Lomax N. Gamma knife radiosurgery for prolactinomas. J Neurosurg. 2000;93(suppl 3):14\u201318."},{"issue":"5)(suppl","key":"b22","series-title":"J Neurosurg","first-page":"415","article-title":"Effects of gamma knife radiosurgery of pituitary adenomas on pituitary function","volume":"97","author":"Feigl GC","year":"2002","unstructured":"Feigl GC, Bonelli CM, Berghold A, Mokry M. Effects of gamma knife radiosurgery of pituitary adenomas on pituitary function. J Neurosurg. 2002;97(5)(suppl):415\u2013421."},{"issue":"5","key":"b23","series-title":"J Neurosurg","first-page":"1499","article-title":"Radiation dose to neuroanatomical structures of pituitary adenomas and the effect of Gamma Knife radiosurgery on pituitary function","volume":"132","author":"Pomeraniec IJ","year":"2019","unstructured":"Pomeraniec IJ, Taylor DG, Cohen-Inbar O,  Radiation dose to neuroanatomical structures of pituitary adenomas and the effect of Gamma Knife radiosurgery on pituitary function. 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Neurosurgery. 2013;72(4):630\u2013637."},{"issue":"4","key":"b27","series-title":"Clin Endocrinol (Oxf)","first-page":"524","article-title":"Gamma knife radiosurgery in patients with persistent acromegaly or Cushing\u2019s disease: long-term risk of hypopituitarism","volume":"84","author":"Cohen-Inbar O","year":"2016","unstructured":"Cohen-Inbar O, Ramesh A, Xu Z,  Gamma knife radiosurgery in patients with persistent acromegaly or Cushing\u2019s disease: long-term risk of hypopituitarism. Clin Endocrinol (Oxf). 2016;84(4):524\u2013531."},{"issue":"7","key":"b28","series-title":"J Clin Endocrinol Metab","first-page":"3105","article-title":"Gamma-knife radiosurgery in acromegaly: a 4-year follow-up study","volume":"88","author":"Attanasio R","year":"2003","unstructured":"Attanasio R, Epaminonda P, Motti E,  Gamma-knife radiosurgery in acromegaly: a 4-year follow-up study. J Clin Endocrinol Metab. 2003;88(7):3105\u20133112."},{"issue":"1","key":"b29","series-title":"J Neurosurg","first-page":"157","article-title":"Assessment of imaging studies used with radiosurgery: a volumetric algorithm and an estimation of its error. Technical note","volume":"104","author":"Snell JW","year":"2006","unstructured":"Snell JW, Sheehan J, Stroila M, Steiner L. Assessment of imaging studies used with radiosurgery: a volumetric algorithm and an estimation of its error. Technical note. J Neurosurg. 2006;104(1):157\u2013162."},{"issue":"10","key":"b30","series-title":"J Clin Endocrinol Metab","first-page":"3717","article-title":"Treatment and follow-up of clinically nonfunctioning pituitary macroadenomas","volume":"93","author":"Dekkers OM","year":"2008","unstructured":"Dekkers OM, Pereira AM, Romijn JA. Treatment and follow-up of clinically nonfunctioning pituitary macroadenomas. J Clin Endocrinol Metab. 2008;93(10):3717\u20133726."},{"issue":"6","key":"b31","series-title":"Endocr Practice","first-page":"757","article-title":"Pituitary adenoma: a clinician\u2019s perspective","volume":"14","author":"Vance ML","year":"2008","unstructured":"Vance ML. Pituitary adenoma: a clinician\u2019s perspective. Endocr Practice. 2008;14(6):757\u2013763."},{"issue":"1","key":"b32","series-title":"J Neurooncol","first-page":"67","article-title":"Prognostic significance of corticotroph staining in radiosurgery for non-functioning pituitary adenomas: a multicenter study","volume":"135","author":"Cohen-Inbar O","year":"2017","unstructured":"Cohen-Inbar O, Xu Z, Lee CC,  Prognostic significance of corticotroph staining in radiosurgery for non-functioning pituitary adenomas: a multicenter study. J Neurooncol. 2017;135(1):67\u201374."},{"issue":"9","key":"b33","series-title":"Acta Neurochir (Wien)","first-page":"1697","article-title":"Radiosurgery for infundibulum adenoma: stalk dose implications","volume":"158","author":"Sokolowski JD","year":"2016","unstructured":"Sokolowski JD, Cohen-Inbar O, Sheehan JP. Radiosurgery for infundibulum adenoma: stalk dose implications. Acta Neurochir (Wien). 2016;158(9):1697\u20131700."},{"issue":"6","key":"b34","series-title":"Pituitary","first-page":"820","article-title":"Gamma Knife radiosurgery for medically and surgically refractory prolactinomas: long-term results","volume":"18","author":"Cohen-Inbar O","year":"2015","unstructured":"Cohen-Inbar O, Xu Z, Schlesinger D,  Gamma Knife radiosurgery for medically and surgically refractory prolactinomas: long-term results. Pituitary. 2015;18(6):820\u2013830."},{"issue":"5","key":"b35","series-title":"J Neurosurg","first-page":"1507","article-title":"Primary versus postoperative stereotactic radiosurgery for acromegaly: a multicenter matched cohort study","volume":"132","author":"Mohammed N","year":"2019","unstructured":"Mohammed N, Ding D, Hung YC,  Primary versus postoperative stereotactic radiosurgery for acromegaly: a multicenter matched cohort study. J Neurosurg. 2019;132(5):1507\u20131516."},{"issue":"1","key":"b36","series-title":"Radiother Oncol","first-page":"119","article-title":"Dosimetric factors associated with pituitary function after Gamma Knife Surgery (GKS) of pituitary adenomas","volume":"104","author":"Sicignano G","year":"2012","unstructured":"Sicignano G, Losa M, del Vecchio A,  Dosimetric factors associated with pituitary function after Gamma Knife Surgery (GKS) of pituitary adenomas. Radiother Oncol. 2012;104(1):119\u2013124."},{"issue":"6","key":"b37","series-title":"Clin Endocrinol (Oxf)","first-page":"643","article-title":"Hypothalamic hypopituitarism following cranial irradiation for nasopharyngeal carcinoma","volume":"24","author":"Lam KS","year":"1986","unstructured":"Lam KS, Wang C, Yeung RT,  Hypothalamic hypopituitarism following cranial irradiation for nasopharyngeal carcinoma. Clin Endocrinol (Oxf). 1986;24(6):643\u2013651."},{"issue":"11","key":"b38","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1857","article-title":"Hypothalamic, pituitary and thyroid dysfunction after radiotherapy to the head and neck","volume":"8","author":"Samaan NA","year":"1982","unstructured":"Samaan NA, Vieto R, Schultz PN,  Hypothalamic, pituitary and thyroid dysfunction after radiotherapy to the head and neck. Int J Radiat Oncol Biol Phys. 1982;8(11):1857\u20131867."},{"issue":"6","key":"b39","series-title":"J Neurosurg","first-page":"1002","article-title":"Stereotactic radiosurgery for recurrent surgically treated acromegaly: comparison with fractionated radiotherapy","volume":"88","author":"Landolt AM","year":"1998","unstructured":"Landolt AM, Haller D, Lomax N,  Stereotactic radiosurgery for recurrent surgically treated acromegaly: comparison with fractionated radiotherapy. J Neurosurg. 1998;88(6):1002\u20131008."},{"issue":"4","key":"b40","series-title":"AJNR Am J Neuroradiol","first-page":"661","article-title":"Reduced hypothalamic blood flow after radiation treatment of nasopharyngeal cancer: SPECT studies in 34 patients","volume":"12","author":"Chieng PU","year":"1991","unstructured":"Chieng PU, Huang TS, Chang CC,  Reduced hypothalamic blood flow after radiation treatment of nasopharyngeal cancer: SPECT studies in 34 patients. AJNR Am J Neuroradiol. 1991;12(4):661\u2013665."},{"issue":"6","key":"b41","series-title":"Acta Endocrinol (Copenh)","first-page":"827","article-title":"Long-term effects of radiotherapy for acromegaly on circulating prolactin","volume":"121","author":"Ciccarelli E","year":"1989","unstructured":"Ciccarelli E, Corsello SM, Plowman PN,  Long-term effects of radiotherapy for acromegaly on circulating prolactin. Acta Endocrinol (Copenh). 1989;121(6):827\u2013832."},{"issue":"2","key":"b42","series-title":"Clin Oncol (R Coll Radiol)","first-page":"79","article-title":"Radiotherapy for pituitary adenomas: an endocrinologist\u2019s perspective","volume":"8","author":"O\u2019Halloran DJ","year":"1996","unstructured":"O\u2019Halloran DJ, Shalet SM. Radiotherapy for pituitary adenomas: an endocrinologist\u2019s perspective. Clin Oncol (R Coll Radiol). 1996;8(2):79\u201384."},{"issue":"4","key":"b43","series-title":"J Intern Med","first-page":"454","article-title":"The hypothalamus-pituitary function after pituitary stereotactic radiosurgery: evaluation of growth hormone deficiency","volume":"253","author":"Degerblad M","year":"2003","unstructured":"Degerblad M, Brismar K, R\u00e4hn T, Thor\u00e9n M. The hypothalamus-pituitary function after pituitary stereotactic radiosurgery: evaluation of growth hormone deficiency. J Intern Med. 2003;253(4):454\u2013462."},{"issue":"4","key":"b44","series-title":"J Neurosurg","first-page":"1188","article-title":"Hypopituitarism after Gamma Knife radiosurgery for pituitary adenomas: a multicenter, international study","volume":"131","author":"Cordeiro D","year":"2019","unstructured":"Cordeiro D, Xu Z, Mehta GU,  Hypopituitarism after Gamma Knife radiosurgery for pituitary adenomas: a multicenter, international study. J Neurosurg. 2019;131(4):1188\u20131196."},{"issue":"1","key":"b45","series-title":"J Neurosurg","first-page":"155","article-title":"Inception of a national multidisciplinary registry for stereotactic radiosurgery","volume":"124","author":"Sheehan JP","year":"2016","unstructured":"Sheehan JP, Kavanagh BD, Asher A, Harbaugh RE. Inception of a national multidisciplinary registry for stereotactic radiosurgery. 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