Treatment of cavernous sinus tumors with linear accelerator radiosurgery

Since 1989, 79 patients with benign or malignant cavernous sinus tumors, ha ve been treated at Stanford University with linear accelerator (linac) radi osurgery. Radio-surgery has been used as (1) a planned second-stage procedu re for residual tumor following surgery (2) primary treatment for patients whose medical conditions preclude surgery, (3) palliation of malignant lesi ons, and (4) definitive treatment-for small. well-localized, poorly accessi ble tumors. Mean patient age was 52 years (range, 18 to 88); there were 28 males and 51 females. Sixty-one patients had benign tumors; 18 had malignan t tumors. Mean tumor volume was 6.8 cm(3) (range 0.5 to 22.5 cm(3)) covered with an average of 2.3 isocenter (range, 1 to 5). Radiation dose averaged 17.1 Gy. Mean follow-up was 46 months. Tumor control or shrinkage, or both, varied with pathology. Radiographic tamer improvement was most pronounced in malignant lesions, with greater than 85% showing reduction in tumor size ; benign tumors (meningiomas and; schwannomas) had a 63% control rate and 3 7% shrinkage rate, with none enlarging. We concluded that stereotactic radi osurgery is a valuable tool in managing cavernous sinus tumors. There was e xcellent control and stabilization of benign tumors and palliation of malig nant lesions.