Abstract
The role of stereotactic radiosurgery/stereotactic radiotherapy (SRS/SRT) for malignant skull base tumors was summarized and discussed. The treatment of skull base tumors remains challenging. Their total resection is often difficult. SRS/SRT is one useful treatment option for residual or recurrent tumors after surgical resection in cases of primary skull base tumors. If skull base metastasis and skull base invasion are relatively localized, they can be candidates for SRS/SRT. Low rates of cervical lymph node involvement in early-stage (N0M0, no lymph node involvement or distant metastasis) nasal and paranasal carcinomas (NpNCa) and external auditory canal carcinomas (EACCa) have been reported in the literature. Such cases might be good candidates for SRS/SRT as the initial therapy. We previously reported the results of SRS/SRT for various malignant extra-axial skull base tumors. In addition, treatment results of early-stage head and neck carcinomas were summarized. Those of our data and those of other reported series were reviewed here to clarify the usefulness of SRS/SRT for malignant extra-axial skull base tumors.
Highlights
BackgroundTreatment of skull base tumors is challenging
We have hitherto reported the results of Stereotactic radiosurgery/stereotactic radiotherapy (SRS/SRT) for various malignant extra-axial skull base tumors [3,4,5,6,7,8,9,10,11,12,13]
Murakami et al reported a case of skull base mesenchymal chondrosarcoma, surviving more than 10 years after the initial surgery, with repeated SRS/SRT in addition to surgical resection 10 times [32]
Summary
Treatment of skull base tumors is challenging. Their total resection is often difficult, as they involve or are located adjacent to various important structures including cranial nerves, major vessels, and the brainstem [1]. Stereotactic radiosurgery/stereotactic radiotherapy (SRS/SRT) is one treatment option for residual or recurrent tumors after surgical resection in cases of primary skull base tumors such as chordoma, paraganglioma, and non-benign meningioma [2]. Murakami et al reported a case of skull base mesenchymal chondrosarcoma, surviving more than 10 years after the initial surgery, with repeated SRS/SRT in addition to surgical resection 10 times [32]. Skull base infiltrations by direct invasion of a regional primary malignant tumor of head and neck cancers, for example along the cranial nerve routes, often occur Both metastasis and invasion by carcinomas, when localized, can be treated effectively by SRS/SRT. Minniti et al reported the effectiveness of SRT, good local control and neurological improvement, in cases of skull base metastases involving the anterior visual pathway [44] They delivered 25 Gy in five fractions. The optimal treatment protocols for early-stage nasal and paranasal carcinomas and external ear canal carcinomas have to be established
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