Radiotherapy in Benign Tumours

Chapter 6 - The Essentials in Radiation Oncology for Brain Tumours

 

RT is highly effective in benign tumours which cannot be surgically removed. Treatment is usually reserved for progressive, rather than stable tumours.

In Grade 1 meningiomas, usually in skull base location, high-precision fractionated treatment achieves excellent tumour control with little toxicity. Small meningiomas are also effectively treated with single-fraction SRS.

RT is highly effective in the control of residual/recurrent pilocytic astrocytoma, particularly when used for optic pathway glioma and tumours in surgically poorly accessible locations.

RT also achieves excellent tumour control of progressive residual or recurrent non-functioning pituitary adenomas and craniopharyngiomas, and leads to hormone normalisation in the majority of secreting tumours, albeit with a delay.

Fractionated high-precision RT and single-fraction SRS (for small lesions) achieve 90% control rate of VIIIth nerve schwannomas (acoustic neuromas).

Cystic components of benign tumours, particularly craniopharyngioma and acoustic neuroma, may enlarge during or shortly after RT, causing mass effect and hydrocephalus. They require close monitoring and appropriate and timely treatment.

Revision Questions

  1. Name six benign tumours that can be treated with RT.
  2. What is the indication for SRS in acoustic neuroma?
  3. What precaution is needed during or after treatment of benign tumours with cystic component and why?

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Last update: 18 September 2017