Radiation Therapy for Skull Base Tumors

Radiation therapy is the use of high levels of energy to destroy cells in both benign and cancerous tumors. It may be used as the main treatment for skull base tumors in people unable to have surgery because of advanced age or other health conditions.

For some types of tumors, radiation therapy may be used after surgery to prevent any remaining tumor cells from growing. These tumors may include adenoid cystic carcinomas, pituitary tumors, meningiomas, esthesioneuroblastomas, chordomas, and chondrosarcomas.

Physicians at NYU Langone may use stereotactic radiosurgery, stereotactic radiotherapy, or intensity modulated radiation therapy to manage skull base tumors.

Stereotactic Radiosurgery or Gamma Knife Surgery

NYU Langone physicians at the Center for Advanced Radiosurgery may use stereotactic radiosurgery—also called Gamma Knife® surgery—to manage small skull base tumors in people who can’t have surgery. It may also be used on small portions of tumors that are not completely removed by surgery. Despite the name, Gamma Knife® is not a knife but rather a system for delivering very precisely targeted radiation treatment.

Working together, our neurosurgeons and radiation oncologists use highly detailed MRI or CT images to create a customized treatment plan for the skull base tumor. Then, the Gamma Knife® system directs multiple highly targeted radiation beams to the tumor in one treatment session. Critical neighboring structures receive only a low radiation dose.

Because Gamma Knife® surgery depends on the precise delivery of radiation beams, people being treated wear a head frame during the procedure, which prevents them from moving. This allows for the precise positioning of the treatment target.

Gamma Knife® surgery is an outpatient procedure and usually takes only a few hours to complete.

Stereotactic Radiotherapy

Our experts may use fractionated stereotactic radiotherapy in people who have tumors that are too large to be managed with Gamma Knife® surgery. This approach uses MRI or CT imaging results and treatment planning software to deliver highly targeted radiation therapy.

Doctors give fractionated stereotactic radiotherapy in lower daily doses over a few weeks to treat the skull base tumor. This decreases the side effects of radiation therapy.

Intensity Modulated Radiation Therapy

Intensity modulated radiation therapy may be used to manage large skull base tumors in people who can’t have surgery, stereotactic radiosurgery, or radiotherapy. Doctors may also use this approach in people who have large portions of a tumor remaining after surgery.

Radiation therapy is guided by computer software that incorporates MRI scans or CT scans of a tumor. The computer-generated images help doctors accurately target tumors, while avoiding damage to healthy areas of the brain.

This type of radiation is known as fractionated therapy, meaning the radiation doses are broken up into smaller doses called fractions. They are usually delivered once a day, five days a week, for several weeks.

During this treatment, doctors use computer-controlled beams of radiation in different intensities. These beams are sculpted in three dimensions to closely conform to the size and shape of the skull base tumor. This approach enables doctors to avoid healthy brain or spinal cord tissue that does not need to be treated, reducing the risk of side effects.

Managing Side Effects

NYU Langone physicians use targeted radiation therapy to avoid side effects, such as problems with thinking or processing information clearly. Other side effects—such as dry mouth, nausea, and vomiting—can be managed with medications or our integrative health services.

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