The role of stereotactic radiosurgery in the treatment of malignant skull base tumors |
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Authors: | RC Miller RL Foote RJ Coffey DA Gorman JD Earle PJ Schomberg RW Kline |
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Affiliation: | Division of Radiation Oncology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA. |
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Abstract: | PURPOSE: To determine the efficacy and toxicity of stereotactic radiosurgery in the treatment of malignant skull base tumors. METHODS AND MATERIALS: Thirty-two patients with 35 newly diagnosed or recurrent malignant skull base tumors < or = 33.5 cm3 were treated using the Leksell Gamma unit. Tumor histologies included: adenoid cystic carcinoma 12], basal cell carcinoma 1], chondrosarcoma 1], chordoma 8], nasopharyngeal carcinoma 3], osteogenic sarcoma 2], and squamous cell carcinoma 8]. RESULTS: After a median follow-up of 2.3 years, 83% +/- 15% (+/-95% confidence interval) of patients experienced a symptomatic response to treatment. Local control at the skull base was 95 +/- 9% at 2 years and 78 +/- 23% at 3 years. Local-regional control above the clavicles was 75 +/- 15% at 1 year and 51 +/- 20% at 2 years. Overall and cause specific survival were identical, 82 +/- 13% at 1 year, 76 +/- 14% at 2 years, and 72 +/- 16% at 3 years. One patient developed a radiation-induced optic neuropathy 12 months after radiosurgery. CONCLUSION: Stereotactic radiosurgery using the Leksell Gamma Unit can provide durable tumor control and symptomatic relief with acceptable toxicity in the majority of patients with malignant tumors 4 cm or less in size involving the skull base. Further evaluation of more patients with longer follow-up is warranted. |
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