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Skull Base Tumors: Fractionated Stereotactic Radiotherapy Perspective

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Principles and Practice of Stereotactic Radiosurgery

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Abstract

Skull base tumors encompass a broad spectrum of different intracranial benign or malignant neoplasms with a great variety of histologies and locations. Taken together, they account for up to a third of all intracranial tumors. The most common types are represented by meningioma, pituitary adenoma, schwannoma of the acoustic nerve, craniopharyngioma, optic chiasm and optic nerve glioma, chordoma and chondrosarcoma, chemodectoma or paraganglioma, giant cell tumors, and carcinoma of the skull base. Some, like the meningioma, can involve almost any part of the anterior, middle, or posterior fossa, whereas others, like the chemodectoma, arise from welldefined anatomic structures such as, for example, the foramen jugulare. Surgery still remains the cornerstone in the management of most skull base tumors [1]. However, in spite of a better understanding of the natural behavior of these tumors, the great progress in anesthesiology, and the refinements in surgical techniques, a complete surgical removal is impossible in many instances or made at a price of considerable neurologic deficits. This is why noninvasive treatments, such as radiotherapy and in particular high-precision radiotherapy, that is, radiosurgery (RS), stereotactic fractionated radiotherapy (STRT), intensity-modulated radiation therapy (IMRT), and particle therapy, play an increasing role in the multidisciplinary management of most skull base tumors.

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References

  1. Prabhu S, Demonte F. Treatment of skull base tumors. Curr Opin Oncol 2003; 15:209–212.

    Article  PubMed  Google Scholar 

  2. Watkins L, Khudados ES, Kaleoglu M, et al. Skull base chordoma: a review of 38 patients, 1955–88. Br J Neurosurg 1993; 7:241–248.

    Article  CAS  PubMed  Google Scholar 

  3. Bouropoulou V, Bosse A, Roessner A, et al. Immunohistochemical investigation of chordomas: histogenic and differential diagnostic apsects. Curr Top Pathol 1989; 80:183–203.

    CAS  PubMed  Google Scholar 

  4. Sell M, Sampaolo S, Di Lorio G, et al. Chordomas: a histological and immunohistochemical study of cases with or without recurrent tumors. Clin Neuropathol 2004; 23:277–285.

    CAS  PubMed  Google Scholar 

  5. Catton C, O’Sullivan B, Bell R, et al. Chordoma: long-term followup after radical photon irradiation. Radiother Oncol 1995; 41:67–70.

    Google Scholar 

  6. Maire JP, Liguoro D, San Gelli F. Volume tumoral macroscopique (GTV) et volume-cible anatomoclinique (CTV) dans la radiothérapie des tumeurs bénignes de la base du crâne. Cancer Radiother 2001; 5:581–596.

    CAS  PubMed  Google Scholar 

  7. Cianfriglia F, Pompili A, Occhipiati E. Intercranial malignant cartilaginous tumors. Report of 2 cases and review of literature. Act Neurochir 1978; 45:163–175.

    Article  CAS  Google Scholar 

  8. Gay E, Sekhar LN, Rubinstein E, et al. Chordomas and chondrosarcomas of the cranial base: results and follow-up of 60 patients. Neurosurgery 1995; 36:887–896.

    Article  CAS  PubMed  Google Scholar 

  9. Noel G, Jaffret E, de Crevoisier R, et al. Irradiation par association de photons et de protons des chordomes et des chondrosarcomes de la base de crâne et du rachis cervical. Bull Cancer 2002; 89:713–723.

    PubMed  Google Scholar 

  10. Castro JR, Linstadt DE, Bahary JP, et al. Experience in charged particle irradiation of tumors of the skull base: 1977–1992. Int J Radiat Oncol Biol Phys 1994; 29:647–655.

    CAS  PubMed  Google Scholar 

  11. Korten AGC, ter Berg HJW, Spincemaille GH, et al. Intracranial chondrosarcoma: review of the literature and report of 15 cases. J Neurol Neurosurg Psychiatry 1998; 65:88–92.

    Article  CAS  PubMed  Google Scholar 

  12. Debus J, Schulz-Ertner D, Schad L, et al. Stereotactic fractionated radiotherapy for chordomas and chondrosarcomas of the skull base. Int J Radiat Oncol Biol Phys 2000; 47:591–596.

    Article  CAS  PubMed  Google Scholar 

  13. Hug EB, Loredo LN, Slater JD, et al. Proton radiation therapy for chordomas and chondrosarcomas of the skull base. J Neurosurg 1999; 91:432–439.

    Article  CAS  PubMed  Google Scholar 

  14. Munzenrider JE, Liebsch NJ. Proton therapy for tumors of the skull base. Strahlenther Onkol 1999; S2(Suppl):57–63.

    Article  Google Scholar 

  15. Crockard HA, Steel T, Plowman N, et al. A multidisciplinary team approach to skull base chordomas. J Neurosurg 2001; 95:175–183.

    Article  CAS  PubMed  Google Scholar 

  16. Crockard HA, Cheeseman A, Steel T, et al. A multidisciplinary team approach to skull base chondrosarcomas. J Neurosurg 2001; 95:184–189.

    Article  CAS  PubMed  Google Scholar 

  17. Koch BB, Karnell LH, Hoffman HT, et al. National Cancer database report on chondrosarcoma of the head and neck. Head Neck 2000; 22:408–425.

    Article  CAS  PubMed  Google Scholar 

  18. Roseberg AE, Nielsen GP, Keel SB, et al. Chondrosarcoma of the base of the skull: a clinicopathologic study of 200 cases with emphasis on its distinction from chordoma. Am J Surg Pathol 1999; 23:1370–1378.

    Article  Google Scholar 

  19. Hassounah M. Al-Mefty O, Akhtar M, et al. Primary cranial and intracranial chondrosarcoma. A survey. Acta Neurochir 1985; 78:123–132.

    Article  CAS  Google Scholar 

  20. Neff B, Sataloff RT, Storey L, et al. Chondrosarcoma of the skull base. Laryngoscope 2002; 112:134–139.

    Article  PubMed  Google Scholar 

  21. Krayenbuhl H, Yasargil MG. Cranial chordomas. Prog Neurol Surg 1975; 6:380–434.

    Google Scholar 

  22. Rich TA, Schiller A, Suit HD, et al. Clinical and pathologic review of 48 cases of chordoma. Cancer 1985; 56:182–187.

    Article  CAS  PubMed  Google Scholar 

  23. Pearlman AW, Friedman M. Radical radiation therapy of chordoma. Am J Radiol 1970; 108:333–341.

    Google Scholar 

  24. Austin-Seymour M. Munzenrider J, Goitein M, et al. Fractionated proton radiation therapy of chordoma and low grade chondrosarcoma of the base of the skull. J Neurosurg 1985; 70:13–17.

    Google Scholar 

  25. Fagundes MA, Hug EB, Liebsch NJ, et al. Radiation therapy for chordomas of the base of skull and cervical spine: patterns of failure and outcome after relapse. Int J Radiat Oncol Biol Phys 1995; 15:579–584.

    Google Scholar 

  26. Noel G, Habrand JL, Mammar H. Combination of photon and proton radiation therapy for chordomas and chondrosarcomas of the skull base: the Centre de Protonthérapie d’Orsay experience. Int J Radiat Oncol Biol Phys 2001; 51:392–398.

    CAS  PubMed  Google Scholar 

  27. Igaki H, Tokuuye K, Okumura T, et al. Clinical results of proton beam therapy for skull base chordoma. Int J Radiat Oncol Biol Phys 2004; 60:1120–1126.

    PubMed  Google Scholar 

  28. Crockard A, Macaulay E, Plowman PN. Stereotactic radiosurgery VI. Posterior displacement of the brainstem facilitates safer high dose radiosurgery for clival chordoma. Br J Neurosurg 1999; 13:65–70.

    Article  CAS  PubMed  Google Scholar 

  29. Pollock BE, Foote RL. The evolving role of stereotactic radiosurgery for patients with skull base tumors. J Neurooncol 2004; 69:199–207.

    Article  PubMed  Google Scholar 

  30. Kondziolka D, Lunsford D, Flickinger JC. The role of radiosurgery in the management of chordoma and chondrosarcoma of the cranial base. Neurosurgery 1991; 29:38–45.

    Article  CAS  PubMed  Google Scholar 

  31. Muthukumar N, Kondziolka D, Lunsford LD, et al. Stereotactic radiosurgery for chordoma and chondrosarcoma: further experiences. Int J Radiat Oncol Biol Phys 1998; 41:387–392.

    CAS  PubMed  Google Scholar 

  32. Miller RC, Foote RL, Coffey RJ, et al. The role of stereotactic radiosurgery in the treatment of malignant skull base tumors. Int J Radiat Oncol Biol Phys 1997; 39:977–981.

    CAS  PubMed  Google Scholar 

  33. Feigl GC, Bundschuh O, Gharabaghi A, et al. Evaluation of a new concept for the management of skull base chordomas and chondrosarcomas. J Neurosurg 2005; S102(Suppl):165–170.

    Google Scholar 

  34. Kocher M, Voges J, Staar S, et al. Linear accelerator radiosurgery for recurrent malignant tumors of the skull base. Am J Clin Oncol 1998; 21:18–22.

    Article  CAS  PubMed  Google Scholar 

  35. Tanaka T, Kobayashi T, Kidu Y, et al. The results of gamma knife radiosurgery for malignant skull base tumors. No Shinkei Geka 1996; 24:235–239.

    CAS  PubMed  Google Scholar 

  36. Pamir MN, Kilic T, Türe U, et al. Multimodality management of 26 skull base chordomas with 4-year mean follow-up: experience at a single institution. Acta Neurochir 2004; 146:343–354.

    Article  CAS  Google Scholar 

  37. Thedinger BA, Glasscock ME, Cueva RA, et al. Postoperative radiographic evaluation after acoustic neuroma and glomus jugulare tumor removal. Laryngoscope 1992; 102:261–266.

    Article  CAS  PubMed  Google Scholar 

  38. Brown JS. Glomus jugulare tumors revisited; a ten-year statistical follow-up of 231 cases. Laryngoscope 1985; 95:284–288.

    Article  CAS  PubMed  Google Scholar 

  39. Liscak R, Vladyka V, Wowra B, et al. Gamma-knife radiosurgery of the glomus jugulare tumors—early multicentre experience. Acta Neurochir 1999; 141:1141–1146.

    Article  CAS  Google Scholar 

  40. Hinerman RW, Mendenhall WM, Amdar RJ, et al. Definitive radiotherapy in the management of chemodectomas arising in the temporal bone, carotid body and glomus vagale. Head Neck 2001; 23:363–371.

    Article  CAS  PubMed  Google Scholar 

  41. Eustacchio S, Leber K. Trummer M, et al. Gamma-knife radiosurgery for glomus jugulare tumors. Acta Neurochir 1999; 141:811–818.

    Article  CAS  Google Scholar 

  42. Zabel A, Milker-Zabel S, Huber P, et al. Fractionated stereotactic conformal radiotherapy in the management of large chemodectomas of the skull base. Int J Radiat Oncol Biol Phys 2004; 58:1445–1450.

    Article  PubMed  Google Scholar 

  43. Al-Mefty O, Teixeira A. Complex tumors of the glomus jugulare: criteria, treatment and outcome. J Neurosurg 2002; 97:1256–1265.

    Google Scholar 

  44. Mayer R, Fruhwirth J, Beham A, et al. Radiotherapy as adjunct to surgery for malignant carotid body paragangliomas presenting with lymph node metastases. Strahlenther Onkol 2000; 76:356–360.

    Article  Google Scholar 

  45. Konefal JB, Pilepich MV, Spector GJ, et al. Radiation therapy in the treatment of chemodectomas. Laryngoscope 1987; 97:1331–1335.

    Article  CAS  PubMed  Google Scholar 

  46. Foote RL, Pollok BE, Gorman DA, et al. Glomus jugulare tumors: tumor control and complications after stereotactic radiosurgery. Head Neck 2002; 24:332–339.

    Article  PubMed  Google Scholar 

  47. Pareschi R, Righini S, Destifi D, et al. Surgery of glomus tumors. Skull Base 2003; 13:149–157.

    Article  PubMed  Google Scholar 

  48. Green JD, Brackmann DE, Nguyen CD, et al. Surgical management of previously untreated glomus jugulare tumors. Laryngoscope 1994; 104:917–921.

    PubMed  Google Scholar 

  49. Fisch U, Fagan P, Valavanis A. The infratemporal fossa approach for the lateral skull base. Otolaryngol Clin North Am 1984; 17:513–522.

    CAS  PubMed  Google Scholar 

  50. Sen C, Hagne K, Kachara R., et al. Jugular foramen: microscopic anatomic features and implications for neural preservation with reference to glomus tumors involving the temporal bone. Neurosurgery 2001; 48:838–847.

    Article  CAS  PubMed  Google Scholar 

  51. Nora JD, Hallet JW, O’Brien PC, et al. Surgical resection of carotid body tumors: long-term survival, recurrence and metastasis. Mayo Clin Proc 1988; 63:348–352.

    CAS  PubMed  Google Scholar 

  52. Bastounis E, Maltezos C, Pikolis E, et al. Surgical treatment of carotid body tumors. Eur J Surg 1999; 165:198–202.

    Article  CAS  PubMed  Google Scholar 

  53. Reddy EK, Mansfield CM, Hartman GV. Chemodectoma of glomus jugulare. Cancer 1983; 52:337–340.

    Article  CAS  PubMed  Google Scholar 

  54. Powell S, Peters N, Harmer C. Chemodectoma of the head and neck: results of treatment in 84 patients. Int J Radiat Oncol Biol Phys 1992; 22:919–924.

    CAS  PubMed  Google Scholar 

  55. Spector GJ, Sobol S. Surgery for glomus tumors at the skull base. Otolaryngol Head Neck Surg 1980; 88:524–530.

    CAS  PubMed  Google Scholar 

  56. Rosenwasser H. Long-term results of tehray of glomus jugulare tumors. Arch Otolaryngol 1973; 97:49–54.

    CAS  PubMed  Google Scholar 

  57. Cole JM, Beiler D. Long-term results of treatment for glomus jugulare and glomus vagale tumors with radiotherapy. Laryngoscope 1994; 104:1461–1465.

    CAS  PubMed  Google Scholar 

  58. Springate SC, Haraf D, Weichselbaum RR. Temporal bone chemodectomas—comparing surgery and radiation therapy. Oncology 1991; 5:131–137.

    CAS  PubMed  Google Scholar 

  59. Feigenberg SJ, Mendenhall WM, Hinerman RW, et al. Radiosurgery for paraganglioma of the temporal bone. Head Neck 2002; 24:384–389.

    Article  PubMed  Google Scholar 

  60. Jordan J, Roland PS, McManus C, et al. Stereotactic radiosurgery for glomus jugulare tumors. Laryngoscope 2000; 110:35–38.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiation Oncology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland

    René-Olivier Mirimanoff MD (Professor) & Alessia Pica MD (Doctor)

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  1. René-Olivier Mirimanoff MD
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  2. Alessia Pica MD
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Editors and Affiliations

  1. Department of Neurosurgery, Boston University School of Medicine, Boston, MA, USA

    Lawrence S. Chin MD (Professor and Chairman) (Professor and Chairman)

  2. Department of Radiation Oncology, University of Maryland Medical School, Baltimore, MD, USA

    William F. Regine MD (Professor and Chairman) (Professor and Chairman)

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Mirimanoff, RO., Pica, A. (2008). Skull Base Tumors: Fractionated Stereotactic Radiotherapy Perspective. In: Chin, L.S., Regine, W.F. (eds) Principles and Practice of Stereotactic Radiosurgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-71070-9_39

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  • DOI: https://doi.org/10.1007/978-0-387-71070-9_39

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  • Print ISBN: 978-0-387-71069-3

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