Stereotactic Radiosurgery and Stereotactic Radiotherapy for Malignant Skull Base Tumors

Mori, Yoshimasa; Kida, Yoshihisa; Matsushita, Yasuhiro; Mizumatsu, Shinichiro; Hatano, Manabu

doi:10.7759/cureus.8401

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…The median marginal doses of 12.7–20 Gy were used in these studies of GKS for chordoma from Table 3 . The clinical data from this table showed that the 5-year local control rate of chordoma after Gamma Knife treatment was 21.4%–76%, and the 5-year survival was 67-100 ( 1 , 7 , 11 – 20 ) ( Table 3 ). The tumor control rates from these clinical investigations varied widely, which demonstrated the radio-resistant characteristic of chordomas.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is no doubt that neurosurgical therapy is the first line treatment option for the skull base chordoma, a total resection is often difficult to obtain, due to the invasion of the tumor into skull base and its location being adjacent to numerous important structures, along with a high tumor recurrence rate ( 7 ). The chemotherapy and traditional low-dose radiotherapy is not sensitive to this tumor ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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The role of Gamma Knife radiosurgery in the management of skull base chordoma

Wang

Gao²,

Jian³

et al. 2023

Front. Oncol.

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ObjectiveChordoma is a slow-growing and locally aggressive cancer, which arises from the remnants of the primitive notochord. The first line treatment for the skull base chordoma is neurosurgery. Gamma Knife radiosurgery (GKS) is often be chosen especially in the setting of residual or recurrent chordomas. The purpose of this study is to evaluate the prognosis of patients with skull base chordoma who underwent GKS.MethodsThe present study was a retrospective analysis of 53 patients with skull base chordomas who underwent GKS. Univariate Cox and Kaplan-Meier survival analysis were performed to analyze the relationship between the tumor control time and the clinical characteristics.ResultsThe 1-, 2-, 3-, and 5-year progression free survival (PFS) rates were 87, 71, 51, and 18%, respectively. After performing the univariate analysis, the clinical characteristics were not found to be significantly associated with the time of PFS; however, surgical history, peripheral dose, and tumor volume did have tendencies to predict the prognosis.ConclusionGKS provided a safe and relatively effective treatment for residual or recurrent chordomas after surgical resection. A higher tumor control rate depends on two approaches, an appropriate dose of radiation for the tumor and the accurate identification of the tumor margins.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of Gamma Knife radiosurgery in the management of skull base chordoma

Wang

Gao²,

Jian³

et al. 2023

Front. Oncol.

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“…Of various head and neck cancers, it is reported that the early-stage nasal and paranasal carcinomas [3][4][5] and early-stage external auditory canal carcinomas (EACCa) [1,2] rarely develop regional LN metastasis or cervical lymph node metastases [6]. Such patients might be good candidates for stereotactic radiosurgery (SRS)/SRT as an upfront therapy instead of surgical extirpation as the initial therapy [6].…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Radiotherapy for Localized External Auditory Canal Carcinomas: Report of Four Cases

Mori

Mizumatsu²

2021

Cureus

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External auditory canal carcinoma (EACC) is sometimes diagnosed at an early stage because it arises superficially in the ear canal and may cause ear obstruction symptoms early. In addition, in the early stage of EACCs, involvement of lymph nodes or distant metastases are reported less frequently. And so, stereotactic radiotherapy (SRT) concentrating high-dose radiation on the primary tumor may be an effective option. The aim of this study is to evaluate the preliminary results of upfront SRT for early-stage localized EACCs. Four cases (four females, 84 to 98 years old) with EACC of N0M0 (=no lymph node involvement and no distant metastasis) were treated. All four tumors (0.30 -11.1 ml in volume) were diagnosed as squamous cell carcinoma histologically. A total dose of 24 -33 Gy in 3 -5 fractions (D95 [dose delivered to 95% of the target volume]=100% dose) was delivered by SRT using CyberKnife. All four cases were alive at the end of the follow-up period of 19 to 106 months. In three cases (tumor volume, 0.3 -3.5 ml) the treated tumors had regressed or disappeared by the end of the follow-up period of 106, 28, and 19 months respectively. In the remaining one case, the treated tumor (11.1 ml) regrew and cervical lymph node metastasis occurred, and both were treated with SRT again 6 months and 20 months after the initial SRT respectively. The tumors were still stable at 39 months after the initial SRT. In conclusion, in three cases the small tumors had regressed or disappeared without lymph node involvement or distant metastasis. In the remaining case, additional SRT was performed for recurrent tumors, after which the patient's condition remained stable. SRT may be an effective option for early-stage EACCs.

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“…Clump et al reported the efficacy of SRT, with the most common fractionated regimen being 24 Gy delivered in three fractions, which improved symptoms within one month [ 9 ]. Mori et al reported that if skull base metastasis and skull base invasion are relatively localized, they can be good candidates for SRT [ 10 ]. However, optimal treatment protocols or guidelines have not yet been established.…”

Section: Discussionmentioning

confidence: 99%

CyberKnife Radiotherapy for Skull Base Petroclival Metastases Including Dorello’s Canal: Report of 10 Cases

Miyazaki¹,

Harada²,

Sasaki³

et al. 2020

Cureus

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Skull base petroclival metastases cause diplopia due to abducens nerve palsy. Diplopia is visually disabling, and skull base metastasis is extremely difficult to treat even with microscopic surgery. However, stereotactic radiotherapy with CyberKnife (Accuray Incorporated, Sunnyvale, California) has been very successful in 10 cases. As the abducens nerve runs through Dorello’s canal in the skull base, the radiation dose and fraction were adjusted to avoid damage to the nerve. Since these metastases are not located inside the brain but in the skull base, contrast magnetic resonance imaging (MRI) combined with fluorodeoxyglucose-positron emission tomography (FDG-PET) was essential to detect the cancers.

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Stereotactic Radiosurgery and Stereotactic Radiotherapy for Malignant Skull Base Tumors

Cited by 7 publications

References 38 publications

The role of Gamma Knife radiosurgery in the management of skull base chordoma

The role of Gamma Knife radiosurgery in the management of skull base chordoma

Stereotactic Radiotherapy for Localized External Auditory Canal Carcinomas: Report of Four Cases

CyberKnife Radiotherapy for Skull Base Petroclival Metastases Including Dorello’s Canal: Report of 10 Cases

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