POSTOPERATIVE IRRADIATION OF PATIENTS WITH MALIGNANT-TUMORS OF THE SKULL BASE

To better understand how to irradiate patients after skull-base surger y, the authors of this study analyzed the tumor recurrence patterns in 22 patients with various malignancies. Of these patients, 13 underwen t craniofacial resection, 6 had infratemporal fossa resection, and 3 h ad 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 par tial-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 scars in 5 patients, and in the lymph nodes in 4 patients. Based on the stu dy findings, the authors state that irradiation of the entire operativ e field, including scars and potential areas of contiguous spread, may be necessary to maximize local control after skull-base surgery.