The Use of Radiosurgery for Salvage in Recurrent Tumors of the Skull Base

Purpose: To retrospectively evaluate the efficacy of radiosurgery in recurrent head and neck cancer. Materials and Methods: During a five-year period, 17 patients with cranial base tumors were treated with radiosurgery, 16 of those after failure of conventional surgery and/or irradiation. There were eight patients with squa- mous cell carcinomas; three nasopharynx; three paranasal si- nuses; one ear; and one soft palate. Three patients had primary adenocarcinomas: one buccal mucosa; one prostate; and one un- known primary site. The remaining tumors were of the following histological types: three clivus chordomas; two chondrosarco- mas; and one rhabdomyosarcoma. A Leksell Gamma Knife unit was used. Doses ranged from 11 Gy to 23 Gy, depending on the tumor volume. Patient age ranged from 9 to 85-years-old, with a median of 50. Mean treatment volume was 27 cc. Median study follow-up was 45 months, ranging from 9 to 68 months. Results: All patients obtained palliation. Local control was obtained in 11 (65%) of the 17 patients. The overall median survival was 38 months. Conclusion: Gamma Knife Radiosurgery should be considered as an alternative method for palliation and retreatment of cranial base recurrence. It offers a safe, effective and non-invasive way of delivering radiation therapy to even a previously treated volume, without overdosing normal adjacent structures. Int Pediatr.