title: Clinical efficacy and safety of surface imaging guided radiosurgery (SIG-RS) in the treatment of benign skull base tumors.
abstract: Frameless, surface imaging guided radiosurgery (SIG-RS) is a novel platform for stereotactic radiosurgery (SRS) wherein patient positioning is monitored in real-time through infra-red camera tracking of facial topography. Here we describe our initial clinical experience with SIG-RS for the treatment of benign neoplasms of the skull base. We identified 48 patients with benign skull base tumors consecutively treated with SIG-RS at a single institution between 2009 and 2011. Patients were diagnosed with meningioma (n = 22), vestibular schwannoma (n = 20), or nonfunctional pituitary adenoma (n = 6). Local control and treatment-related toxicity were retrospectively assessed. Median follow-up was 65 months (range 61-72 months). Prescription doses were 12-13 Gy in a single fraction (n = 18), 8 Gy × 3 fractions (n = 6), and 5 Gy × 5 fractions (n = 24). Actuarial tumor control rate at 5 years was 98%. No grade ≥3 treatment-related toxicity was observed. Grade ≤2 toxicity was associated with symptomatic lesions (p = 0.049) and single fraction treatment (p = 0.005). SIG-RS for benign skull base tumors produces clinical outcomes comparable to conventional frame-based SRS techniques while enhancing patient comfort.
authors.affiliation: Department of Radiation Oncology, University of Texas Southwestern, Dallas, TX, USA.
authors.forename: Steven K M
authors.initials: SKM
authors.lastname: Lau
authors.affiliation: Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, University of California San Diego, La Jolla, CA, USA.
authors.forename: Kunal
authors.initials: K
authors.lastname: Patel
authors.affiliation: Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, University of California San Diego, La Jolla, CA, USA.
authors.forename: Teddy
authors.initials: T
authors.lastname: Kim
authors.affiliation: Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, University of California San Diego, La Jolla, CA, USA.
authors.forename: Erik
authors.initials: E
authors.lastname: Knipprath
authors.affiliation: Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
authors.forename: Gwe-Ya
authors.initials: GY
authors.lastname: Kim
authors.affiliation: Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
authors.forename: Laura I
authors.initials: LI
authors.lastname: Cerviño
authors.affiliation: Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Lawson
authors.affiliation: Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Murphy
authors.affiliation: Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
authors.forename: Parag
authors.initials: P
authors.lastname: Sanghvi
authors.affiliation: Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, University of California San Diego, La Jolla, CA, USA.
authors.forename: Bob S
authors.initials: BS
authors.lastname: Carter
authors.affiliation: Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, University of California San Diego, La Jolla, CA, USA. clarkchen@ucsd.edu.|Center for Theoretical and Applied Neuro-Oncology, Moores UCSD Cancer Center, 3855 Health Science Drive, MC 0987, La Jolla, CA, 92093-0987, USA. clarkchen@ucsd.edu.
authors.forename: Clark C
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Benign skull base tumor; Frameless radiosurgery; Image guided radiosurgery; SIG-RS; Stereotactic radiosurgery; Surface imaging guided radiosurgery