This study aims to assess long-term outcomes of hypopituitarism following gamma knife radiosurgery (GKRS) for pituitary adenomas.

Pituitary adenomas (PAs) are one of the most common intracranial neoplasms, accounting for 10-20% of diagnosed brain tumors.

Initial gamma knife radiosurgery (GKRS) can be an alternative treatment for selected NFPA patients with comorbidities, documented growth small tumors, cavernous sinus invasion, or advanced age.

Hypopituitarism is one of the most common complications of radiosurgery (Cordeiro et al., 2018). Long-term follow-up is crucial to assess new pituitary deficits. Typically, hypopituitarism presents within the first 2-4 years after the treatment with radiosurgery, but the risk of pituitary insufficiency increases to up to 80%. Reports on the highest incidence of new-onset hypopituitarism also mentioned the longest follow-up period.

Inclusion Criteria:

• Age ≥18 years.
• Both sexes.
• Patients treated with gamma knife radiosurgery (GKRS).

Exclusion Criteria:

• Patients with inadequate endocrine follow-up (<12 months).
• Patients who had undergone previous radiation therapy.
• Pituitary insufficiency which presents before gamma knife radiosurgery (GKRS).
• Patients without visible glands.

This retrospective cohort study will be conducted in the Department of Neurosurgery, Al-Azhar University Hospital.

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

After the end of study for one year.

The data will be available upon a reasonable request from the corresponding author.