Object Traditionally, the treatment of choice for @entity1 with @entity3 to the calvaria or skull base has been conventional radiation therapy. Because @entity1 with systemic @entity5 are also at risk for intracranial @entity3 , the utility of Gamma Knife surgery (GKS) for these @entity1 has been explored to reduce excess radiation exposure to the perilesional brain parenchyma. The purpose of this study was to report the efficacy of GKS for the treatment of calvarial @entity3 and skull base lesions. Methods The authors performed a retrospective chart review of 21 @entity1 with at least 1 calvarial or skull base metastatic lesion treated with GKS during 2001-2013. For 7 @entity75 , a novel technique, in which a bolus was placed over the treatment site, was used. For determination of local control or disease progression, radiation therapy data were examined and posttreatment MR images and oncology records were reviewed. Survival times from the date of procedure were estimated by using Kaplan-Meier analyses. Results The median @entity1 age at treatment was 57 years (range 29-84 years). A total of 19 (90%) @entity1 received treatment for single lesions, 1 @entity1 received treatment for 3 lesions, and 1 @entity1 received treatment for 4 lesions. The most common @entity5 was @entity0 (24% of @entity1 ). Per lesion, the median clinical and radiographic follow-up times were 10.3 months (range 0-71.9 months) and 7.1 months (range 0-61.3 months), respectively. Of the 26 lesions analyzed, 14 (54%) were located in calvarial bones and 12 (46%) were located in the skull base. The median lesion volume was 5.3 cm(3) (range 0.3-55.6 cm(3)), and the median prescription margin dose was 15 Gy (range 13-24 Gy). The median overall survival time for all @entity1 was 35.9 months, and the 1-year local control rate was 88.9% (95% CI 74.4%-100%). Local control rates did not differ between lesions treated with the bolus technique and those treated with traditional methods or between @entity75 and skull base lesions (p > 0.05). Of the 3 @entity1 for whom local treatment failed, 1 @entity1 received no further treatment and 2 @entity1 responded to salvage chemotherapy. Subsequent brain parenchymal @entity3 developed in 2 @entity1 , who then underwent GKS. Conclusions GKS is an effective treatment modality for @entity1 with @entity3 to the calvarial bones or skull base. For @entity1 with superficial @entity75 , a novel approach with bolus application resulted in excellent rates of local control. GKS provides an effective therapeutic alternative to conventional radiation therapy and should be considered for @entity1 at risk for calvarial @entity3 and brain parenchymal @entity3 .

Calvarial and skull base XXXX : expanding the clinical utility of Gamma Knife surgery.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity75 :: ('MESH:D001927', 'Disease') :: ['calvarial lesions'] @entity5 :: ('MESH:D009369', 'Disease') :: ['primary tumor', 'malignancies'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases']
@entity3 :: (MESH:D009362,Disease) :: ['metastases']
