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Updated: Jun 19, 2026
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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Radiotherapy and radiosurgery for benign skull base meningiomas
Giuseppe Minniti1, Maurizio Amichetti, Riccardo Maurizi Enrici
1Department of Radiotherapy Oncology, Sant' Andrea Hospital, University La Sapienza, Rome, Italy. gminniti@ospedalesantandrea.it
Radiation Oncology (London, England)
|October 16, 2009
Summary
Skull base meningiomas are challenging tumors. Advanced radiation techniques like stereotactic radiosurgery (SRS) and fractionated radiotherapy (FSRT) offer high tumor control rates with reduced toxicity for these difficult-to-access tumors.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Skull base meningiomas present significant surgical challenges due to their location.
- Surgical removal often involves complex approaches, leading to high morbidity.
- Subtotal excision of benign meningiomas can be complemented by radiation therapy for local control.
Purpose of the Study:
- To review and compare the efficacy and toxicity of various radiation techniques for skull base meningiomas.
- To evaluate the role of advanced radiation modalities in managing these complex tumors.
Main Methods:
- Review of conventional fractionated external beam radiation therapy.
- Analysis of outcomes for stereotactic radiosurgery (SRS).
- Evaluation of fractionated stereotactic radiotherapy (FSRT), intensity-modulated radiotherapy (IMRT), and proton therapy for complex cases.
Main Results:
- Conventional radiotherapy shows up to 95% 5-year progression-free survival after subtotal excision.
- SRS achieves 85-97% tumor control at 5 years but is limited to smaller tumors away from critical structures.
- Fractionated RT techniques (FSRT, IMRT, protons) demonstrate 85-100% tumor control at 5 years with low toxicity for larger or complex meningiomas.
Conclusions:
- Advanced radiation techniques provide effective tumor control for skull base meningiomas, especially for those unsuitable for surgery or SRS.
- Fractionated radiotherapy approaches offer a favorable balance of efficacy and reduced toxicity for complex cases.
- Longer follow-up and larger studies are needed to definitively compare the long-term outcomes and toxicity of different radiation techniques.
