Radiotherapy regimens and concurrent Cabergoline use for non-functioning pituitary neuroendocrine tumors: a large, single-center cohort

Geovanne Pedro Mauro; Lucas Gonçalves Rebello; Leila Maria Da Róz; Vinicius de Carvalho Gico; Eduardo Weltman; Evandro César de Souza; Rafael Loch Batista; Malebranche Berardo Carneiro da Cunha Neto; Rosangela Correa Villar

doi:10.1007/s12020-025-04473-8

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Radiotherapy regimens and concurrent Cabergoline use for non-functioning pituitary neuroendocrine tumors: a large, single-center cohort

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Radiotherapy regimens and concurrent Cabergoline use for non-functioning pituitary neuroendocrine tumors: a large, single-center cohort

Geovanne Pedro Mauro, Lucas Gonçalves Rebello, Leila Maria Da Róz, Vinicius de Carvalho Gico, Eduardo Weltman, Evandro César de Souza, Rafael Loch Batista, Malebranche Berardo Carneiro da Cunha Neto and Rosangela Correa Villar

Endocrine, Vol.91(1), p.60

02/03/2026

DOI: 10.1007/s12020-025-04473-8

PMCID: PMC12864329

PMID: 41629547

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Abstract

Background The standard treatment for non-functioning pituitary neuroendocrine tumors (PitNET) consists in transsphenoidal surgical resection, however when progression or recurrence happens, additional treatments like stereotactic radiotherapy (SRT) and dopaminergic agonists can be used. In this article we aim to describe and quantify the impact of SRT regimen and dose, as well as the use of concurrent cabergoline, on local tumor control and toxicities. Methods This is a retrospective cohort of patients with non-functioning PitNET treated between 2008 and 2023 with LINAC-based SRT on different dose regimens with or without cabergoline, in a single university hospital. Results One-hundred twenty-six (126) patients were assessed. Median follow-up was 62.6 months (7.1 – 135.8 months). Most patients already had a visual deficit (65.1%) or hormonal dysfunction (52.4%) before SRT. Lesion size (median larger diameter is 2.5cm) and younger age were correlated with the use of fractionated SRT (FRT) (respectively, p>0.001 and p=0.006). 5 year control rate was 96.8%. For single-dose radiosurgery (SRS), they were 90.5% and 57.2 months, respectively. For FRT, 66.7% and 44.9 months, respectively. Cabergoline use did not influence results. There were no differences in new hormonal deficits among groups. Symptomatic radionecrosis was reported in only one patient. Strokes and CNS bleeding were reported in three patients. There were no secondary malignancies reported. Conclusion No difference was found between SRS and FRT, the usage of cabergoline did not affect response. SRT brings good control with low toxicity in non-functional PitNET. However further prospective research is needed.

Radiotherapy

Pituitary adenomas

Stereotactic

Radiosurgery

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Title: Subtitle: Radiotherapy regimens and concurrent Cabergoline use for non-functioning pituitary neuroendocrine tumors: a large, single-center cohort
Creators: Geovanne Pedro Mauro - University of Iowa, Radiation Oncology
Lucas Gonçalves Rebello - Universidade de São Paulo
Leila Maria Da Róz - Universidade de São Paulo
Vinicius de Carvalho Gico - Instituto do Câncer do Estado de São Paulo
Eduardo Weltman - Universidade de São Paulo
Evandro César de Souza - Universidade de São Paulo
Rafael Loch Batista - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
Malebranche Berardo Carneiro da Cunha Neto - Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
Rosangela Correa Villar - Universidade de São Paulo
Resource Type: Journal article
Publication Details: Endocrine, Vol.91(1), p.60
DOI: 10.1007/s12020-025-04473-8
PMID: 41629547
PMCID: PMC12864329
NLM abbreviation: Endocrine
ISSN: 1355-008X
eISSN: 1559-0100
Publisher: Springer Nature
Language: English
Date published: 02/03/2026
Academic Unit: Radiation Oncology
Record Identifier: 9985160642202771

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