Radiation therapy for metastases to the base of the skull

The clinical features and management of 46 patients with metastatic involvement of the base of the skull were retrospectively analyzed. Diagnosis could often be made on clinical grounds, with a limited number of investigations necessary. Local treatment with megavoltage radiotherapy relieved symptoms in 78% of patients, with improvement lasting until death in most. Field size and dosage are discussed. The likelihood of response dropped sharply the longer treatment was delayed. Therefore, if the clinical picture is suggestive, treatment should not be withheld even if radiographic investigations are negative.