Skull Base Tumor Treatment

Our Treatment Approach

The specialists at MD Anderson take a team approach to skull base tumors, bringing together extraordinary expertise from many areas. We personalize your treatment to deliver the most-advanced care with the least impact on your body.

Skull base tumor patients benefit from the most advanced technology and treatments, many available at only a few locations in the country. Your recommended therapy may include:

• Minimally invasive surgery
• Proton therapy
• Innovative radiotherapy delivery techniques
• Advanced reconstruction surgeries

And we’re constantly researching newer, safer, more-advanced treatments for skull base tumors. This means we are able to offer a range of clinical trials for new treatments.

Our Skull Base Tumor Treatments

If you are diagnosed with a skull base tumor, your doctor will discuss the best options to treat it. This depends on:

• The type of tumor
• The location of the tumor
• Possible side effects of treatment
• Your health

Most skull base tumors may require surgery. Some can be treated without surgery (for example with radiation or chemotherapy). Others do not need to be treated right away and can be watched closely over time.

Your treatment for a skull base tumor will be customized to your particular needs. It may include one or more of the following.

Surgery

Like all surgeries, skull base tumor surgery is most successful when it is done by a specialist with a great deal of experience in the procedure.

MD Anderson’s renowned skull base tumor surgeons work in multi-specialty teams. They perform a high number of skull base tumor surgeries each year, using the least-invasive, most-advanced techniques.

The main types of skull base tumor surgery are:

Open surgery: Incisions (cuts) are made in the skin or the membranes of the nose or throat to expose the bone of the skull base. The incision often can be hidden in the hair, skin creases, nose or mouth.

The affected bone is removed to expose the tumor and to identify the important nerves and blood vessels. After the tumor is removed, the membrane that protects the brain and the surrounding soft tissues is closed to seal off the skull base. Occasionally, when large skull base tumors are treated, plastic surgeons rebuild the soft tissues and bone to optimize function and appearance.

Minimally invasive endoscopic surgery: Using no incisions or a few small ones in the skull or back of sinuses, the surgeon uses an endoscope (link to definition) to biopsy or remove the skull base tumor. This approach may:

• Lessen damage to healthy tissue
• Lessen time in hospital and recovery time
• Reduce complications

Image-guided surgery: CT (computed tomography) or MRI (magnetic resonance imaging) scans are taken before surgery. They then are used in the operating room to help guide the surgeon to the precise location of the tumor. This enhances the accuracy and precision of minimally invasive surgery of the skull base.

Real-time MRI: Provides surgeons with precise, "live" images of the tumor and surrounding areas during surgery. This increases the surgeon’s accuracy and the chance for complete removal of the skull base tumor.

Radiation Therapy

New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target skull base tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells. MD Anderson provides the most advanced radiation treatments, including:

Intensity-modulated radiotherapy (IMRT) including:

• 3-D conformal radiation therapy, which uses sophisticated computerized controls to deliver radiation beams from different angles to fit the exact shape of the skull base tumor
• Dynamic multi-leaf collimator (DMLC) uses metal ‘leaves’ to shape the radiation beam that is delivered to the tumor. As the radiotherapy arm moves, the computer-controlled ‘leaves’ are repositioned so that radiation beams can target even irregularly shaped skull base tumors.

Radiosurgery, such as Gamma Knife, focuses one large dose of radiation to small tumors (less than 3 centimeters)

Proton therapy: The Proton Therapy Center at MD Anderson is one of the largest and most advanced centers in the world. It’s the only proton therapy facility in the country located within a comprehensive cancer center. This means that this cutting-edge therapy is backed by all the expertise and compassionate care for which MD Anderson is famous.

Proton therapy delivers high radiation doses directly to the skull base tumor site, while decreasing the risk of damage to nearby healthy tissue. It is especially valuable for some cancers deep in the body (such as skull base tumors) because it is targeted to deposit energy only in the area of the tumor. For some patients, this therapy results in better cancer control with less impact on the body.

Chemotherapy

The choice of chemotherapy is based on the type of tumor cell that is found in the skull base tumor. MD Anderson offers the most up-to-date and advanced chemotherapy options.

Our Skull Base Tumor Clinical Trials

Because of its status as one of the world’s premier cancer centers, MD Anderson participates in several clinical trials (research studies) for skull base tumors.

Studies of treatments based on tumor cell type may include laboratory or imaging tests to see if the treatment is working. Other studies track the quality of life of patients and their families. This may help lessen the effect of the tumor and its treatment on patients’ physical, mental and social well-being.