CLIN-RADIATION THERAPY

ABSTRACT: Skull base tumors are challenging lesions for neurosurgeons, but these cannot always be removed via surgical resection. Helical tomotherapy (HT) delivers small beamlets of photons in continuous rotational treatment arcs and has an advantage of soft-tissue verification using computed tomography. We present our experience with HT for skull base tumors when the tumors were not accessible via surgery or recurred after surgery. From December 2005 to October 2010, 60 patients underwent HT for brain tumors. Among them, 13 patients had skull base tumors; four patients had petroclival meningiomas; two patients had cerebellopontine angle (CPA) meningiomas; two patients had acoustic schwannomas; one patient had foramen magnum meningioma; one patient had sphenoid meningioma; one patient had cavernous meningioma; one patient had jugular foramen meningioma; and one patient had clival meninigioma. Eight patients (62%) underwent surgery before HT. The target size ranged from 0.55 to 141.86 cm3 (median 3.85 cm3), and the target dose ranged from 9 to 57 Gy in 1-31 fractions (median 25 Gy in 5 fractions). The median follow-up period was 11 months. The results of HT for skull base tumors are described in Table 1. Twelve patients (92%) had favorable radiologic response. Six patients (46%) had partial response, and another six patients (46%) had stable disease after HT. One patient with CPA meningioma (case 11) had disease progression and underwent a second surgery. One patient with acoustic schwannoma (case 8) had transient radiation-induced changes on the cerebellum, but other patients did not have radiation-induced complications. HT is a useful treatment modality for skull base tumors when surgical access is not possible, and HT is well tolerated by patients with skull base tumors.

SUBMITTER: Yoon W 

PROVIDER: S-EPMC3488792 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature