Purpose To assess the influence of different treatment modalities on long-term health-related quality of life (HR-QoL) and cognitive problems among patients who had been treated for nonfunctioning pituitary adenoma (NFA).

Methods and Materials Eighty-one patients (49 men and 32 women, aged 55 ±10 years) with a minimal follow up period of 1 year after treatment for NFA participated in this cross-sectional study. Sixty two patients were initially treated by transsphenoidal surgery and 19 by craniotomy. Subsequently, 45 out of these 81 subjects (56%) received additional radiotherapy (RT) after surgery because of a tumor remnant or regrowth. All subjects filled in standardized questionnaires measuring HR-QoL, depression, fatigue and cognitive problems.

Results Patients who underwent additional RT more frequently underwent a craniotomy and were younger at surgery, but not at entering this study. They also used more hormonal substitution. Most HR-QoL domains showed a similar score in patients who underwent RT, when compared with patients who did not receive RT. However, vitality and physical functioning proved to be better in RT subjects, and RT subjects also had better scores for depression, and physical and mental fatigue (all p < 0.05). Some aspects of HR-QoL of patients who have been successfully treated for NFA are reduced compared with the normal population, but this was much more pronounced in the group that did not receive RT. In multivariate analysis, RT remained significantly associated with improved HR-QoL. No diffe-rences in cognitive function scores were observed. Conclusion Postoperative RT in patients with NFA is not associated with reduced quality of life or cognition when compared with surgery alone