Postoperative irradiation of patients with malignant tumors of skull base

To better understand how to irradiate patients after skull-base surgery, the authors of this study analyzed the tumor recurrence patterns in 22 patients with various malignancies. Of these patients, 13 underwent craniofacial resection, 6 had infratemporal fossa resection, and 3 had temporal bone resection. The entire operative field was irradiated in 8 patients (total-field group), and part of the operative field was irradiated in 14 patients (partial-field group). Tumor regrew within the irradiated area in 25% of the total-field group and 14% of the partial-field group. Tumor appeared outside the operative field in 13% of the total-field group and 57% of the partial-field group. Recurrences appeared in contiguous sites in 5 patients, in the unirradiated scar in 5 patients, and in the lymph nodes in 4 patients. Based on the study findings, the authors state that irradiation of the entire operative field, including scars and potential areas of contiguous spread, may be necessary to maximize local control after skull-base surgery.